For patients with metastatic castration-resistant prostate cancer (mCRPC), 8 cycles of docetaxel, in contrast with 6 cycles, may improve superior overall survival, according to a post hoc analysis published in JAMA Oncology.1

This international, randomized, phase 3 Mainsail trail evaluated the efficacy and safety of docetaxel, prednisone, and lenalidomide (DPL) versus docetaxel, prednisone, and placebo (DP), among 1059 patients with mCRPC, until disease progression or unacceptable toxicity.

Median overall in patients treated with DPL was inferior to that of those in the DP arm, and was associated with greater incidence of adverse events.

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Increased toxicity in the DPL arm resulted in the receipt of fewer docetaxel cycles (median, 6 cycles versus 8 cycles). Researchers investigated whether the number of docetaxel cycles administered affected the extent of clinical benefit.

Treatment with 8 cycles or more of docetaxel was associated with superior overall survival (hazard ratio, 1.909; 95% CI, 1.660-2.194; P < .001), regardless of whether patients received lenalidomide (hazard ratio, 1.060; 95% CI, 0.924-1.215; P = .41).

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Patients who received more than 10 cycles had a median overall survival of 33.0 months, compared with 26.9 months for those who received 8 to 10 cycles, and 22.8 months for patients who received only 5 to 7 cycles (P < .001).              


  1. de Morree ES, Vogelzang NJ, Petrylak DP, et al. Association of survival benefit with docetaxel in prostate cancer and total number of cycles administered. JAMA Oncol. 2016 Aug 25. doi: 10.1001/jamaoncol.2016.3000 [Epub ahead of print]