Adjuvant chemotherapy improves survival in prostate cancer patients

Adjuvant chemotherapy improves survival in prostate cancer patients

1 Jun 2015

Men with localized, high-risk prostate cancer gained a first-ever survival benefit with adjuvant chemotherapy following androgen suppression and definitive radiation therapy, a randomized trial showed.

In particular, the analysis of the results revealed that men who received docetaxel had a 4-year overall survival of 93% compared with 89% for men treated with androgen suppression and radiation therapy but no chemotherapy. The 5-year disease-free survival (DFS) was 73% with docetaxel and 66% without.

Design of the randomized trial

Sandler reported findings from a trial designed to determine whether adjuvant docetaxel could improve survival in men with hormone-sensitive, high-risk, localized prostate cancer, a disease category that has a fairly poor prognosis. Investigators in the Radiation Therapy Oncology Group enrolled 612 patients with newly diagnosed, high-risk, localized prostate cancer.

All patients received definitive radiation therapy and standard long-term (24 months) androgen suppression and were randomized to docetaxel plus prednisone for 18 months or no additional therapy. The primary endpoint was 4-year overall survival.

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After a median follow-up of 5.5 years, the primary analysis showed a 30% reduction in the mortality hazard for the docetaxel arm. The difference in DFS translated into a 24% reduction in the hazard in favor of docetaxel. Sandler reported that 41 patients in the control group died as compared with 26 in the docetaxel group.

Statistically significant but still early results

In general, adjuvant docetaxel was associated with a statistically significant reduction in the incidence of distant metastasis. Sandler described docetaxel as generally well tolerated. One grade 5 (death) adverse event occurred in the control arm (unlikely related to treatment) and two in the docetaxel arm (both possibly/probably treatment related).

"For the first time, an improvement in overall survival has been observed with tolerable adjuvant chemotherapy for localized prostate cancer," Sandler said during a press briefing. "The potential role of docetaxel in hormone sensitive prostate cancer is consistent with and supported by our data and other studies. This 4-year analysis is relatively early, and additional follow-up will likely be enlightening."

Source: MedPage Today

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