Adjuvant Docetaxel May Worsen Outcomes vs Surveillance in Prostate Cancer

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It was previously unknown whether chemotherapy or surveillance leads to improved outcomes in prostate cancer post-prostatectomy.
It was previously unknown whether chemotherapy or surveillance leads to improved outcomes in prostate cancer post-prostatectomy.
The following article features coverage from the 2018 Genitourinary Cancers Symposium. Click here to read more of Cancer Therapy Advisor's conference coverage.

Adjuvant docetaxel therapy may have a negative impact on disease progression post-prostatectomy among patients with prostate cancer with low or undetectable prostate-specific antigen (PSA) levels, according to a study presented at the 2018 Genitourinary Cancers Symposium in San Francisco, California.1

It was previously unknown whether chemotherapy or surveillance leads to improved outcomes in prostate cancer post-prostatectomy.

For this open-label phase 3 study (ClinicalTrials.gov Identifier: NCT00376792), researchers enrolled 459 patients with prostate cancer at high risk who had undergone radical prostatectomy and randomly assigned them to receive 6 cycles of adjuvant docetaxel 75 mg/m2 without steroid therapy or to surveillance. The primary endpoint was PSA progression of 0.5 ng/mL or greater.

The median time to progression, death, or last follow up was nearly 57 months. Overall, 44.8% (103/230) and 38% (81/229) of patients in the docetaxel arm and the surveillance arm, respectively, reached the primary endpoint. Excluding the 76 patients who already had PSA levels greater than 0.2 ng/mL after surgery, analysis favored surveillance over docetaxel (P = .02).

Multivariate analysis, which included factors such as Gleason score, pT-stage, surgical margins, and lymph node status, also demonstrated that patients in the surveillance arm had prolonged times to progression (P = .03) vs docetaxel.

The authors concluded that “adjuvant docetaxel without hormonal therapy or continuous corticosteroids may have an adverse effect on biochemical progression in patients with low or undetectable levels of PSA after surgery.”

Read more of Cancer Therapy Advisor's coverage of the 2018 Genitourinary Cancers Symposium by visiting the conference page.

Reference

  1. Ahlgren GM, Borre M, Sengelov L, et al. Adverse effect of docetaxel versus surveillance after radical prostatectomy for high risk prostate cancer: post-hoc analysis of the prospective randomized, open-label phase III SPCG 12 trial. Oral presentation at: 2018 Genitourinary Cancers Symposium; February 8-10, 2018; San Francisco, CA.

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