Chemohormonal therapy prolongs overall survival among patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC), according to a study published in the Journal of Clinical Oncology.1
Interim analyses of the Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer (CHAARTED; ClinicalTrials.gov Identifier: NCT00309985) — as well as results from multiple previous studies — demonstrated that patients with mHSPC treated with docetaxel have prolonged overall survival (OS).
For the open-label phase 3 CHAARTED study, researchers randomly assigned 790 patients to receive docetaxel 75 mg/m2 plus androgen-deprivation therapy (ADT) or ADT alone. Patients were stratified by factors such as age, performance status, and duration of prior ADT therapy, but a key factor was high vs low disease volume.
Long-term analysis, with median follow-up of 53.7 months, showed that the median OS was 57.6 months vs 47.2 months among patients treated with chemohormonal therapy vs ADT alone, respectively (hazard ratio [HR], 0.72; 95% CI, 0.59-0.89; P = .0018).
The median OS among patients with high-volume disease was 51.2 months for patients in the chemohormonal treatment arm vs 34.4 months for patients in the ADT arm (HR, 0.63; 95% CI, 0.50-0.79; P < .001); no OS benefit was observed among patients with low-volume disease (HR, 1.04; 95% CI, 0.70-1.55; P = .86).
The authors concluded that “although burden of metastases determined by conventional imaging can assist in patient selection for treatment with docetaxel, additional studies should focus on identifying more accurate biomarkers and gaining a better understanding of the underlying mechanisms of resistance to ADT and the biologic basis for AR targeting and cytotoxics in prostate cancer.”
- Kyriakopoulos CE, Chen YH, Carducci MA, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial. J Clin Oncol. 2018 Jan 31. doi: 10.1200/JCO.2017.75.3657 [Epub ahead of print]