Docetaxel Improves Prostate Cancer-Specific Survival in Certain Patients

Adding docetaxel to standard treatment can prolong prostate cancer-specific survival in certain patients, according to a meta-analysis published in JAMA Network Open.

Researchers found that docetaxel reduced the risk of prostate cancer-specific death in patients with nonmetastatic prostate cancer who had prostate-specific antigen (PSA) levels below 4 ng/mL, Gleason scores of 8 to 10, and an ECOG performance status score of 0.

This meta-analysis included patients with nonmetastatic prostate cancer who were enrolled in 4 randomized controlled trials. A total of 145 patients had PSA levels less than 4 ng/mL and Gleason scores of 8 to 10, making them eligible for analysis. Most patients (95.9%) had an ECOG performance status score of 0, but 4.1% had a score of 1.

Patients had received standard treatment — radical prostatectomy alone or radiotherapy and androgen deprivation therapy — with docetaxel (n=78) or without it (n=67).

In an adjusted analysis, there was no significant difference in the risk of all-cause death between patients who received docetaxel and those who did not. This was true in the overall cohort (hazard ratio [HR], 0.51; 95% CI, 0.24-1.09) and among patients with a performance status of 0 (HR, 0.46; 95% CI, 0.21-1.02).

In the overall cohort, there was no significant difference in the risk of prostate cancer-specific death between patients who received docetaxel and those who did not (HR, 0.42; 95% CI, 0.17-1.02).

However, patients with a performance status of 0 had a significant reduction in the risk of prostate cancer-specific death if they received docetaxel (HR, 0.30; 95% CI, 0.11-0.86). The unadjusted 8-year prostate cancer-specific mortality rate was 8% with docetaxel plus standard care and 23% with standard care alone.

Based on these results, the researchers concluded that adding docetaxel to standard treatment has the potential to improve prognosis in patients with nonmetastatic prostate cancer who are in otherwise good health, have a PSA level of less than 4 ng/mL, and have a Gleason score of 8 to 10.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Mahal BA, Kwak L, Xie W, et al. Mortality risk for docetaxel-treated, high-grade prostate cancer with low PSA levels: A meta-analysis. JAMA Netw Open. Published online November 1, 2023. doi:10.1001/jamanetworkopen.2023.40787

This article originally appeared on Cancer Therapy Advisor