Men with high-grade prostate cancer and low prostate-specific antigen (PSA) levels have a poor prognosis. The query stays as as to whether the chemotherapy drug docetaxel, which increases survival in metastatic prostate cancer, can improve the cure rate in these patients.
In a brand new study, investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, a meta-analysis of 5 prospective randomized clinical trials (RCTs) found that adding docetaxel to standard-of-care (SOC) treatment was related to a 70% reduction in death from prostate cancer-specific mortality (PCSM). The study was published today in JAMA Network Open.
Investigators performed a meta-analysis of the RCTs evaluating SOC treatment with radiotherapy and androgen deprivation therapy or with radical prostatectomy versus SOC plus docetaxel. The ultimate study cohort of two,184 patients included 145 eligible patients (6.6%) across 4 eligible RCTs.
Of those 145 patients, 139 had excellent performance status [PS] and were the principal focus of the study. A superb PS identifies patients who can tolerate the total course of chemotherapy and due to this fact profit if the treatment proves effective.”
Anthony Victor D’Amico, MD, PhD, chief of Genitourinary Radiation Oncology at Brigham and Women’s Hospital and senior writer of the study
Amongst these 139 patients, SOC plus docetaxel was related to a big 70% reduction in PCSM and nearly halved all-cause mortality. Remarkably, this treatment regiment dropped the 10-year PCSM rate from nearly 40% to lower than 10%, resulting in a 10-year overall survival of 80% as in comparison with 60%.
“It is a marked improvement in survival for these patients, who currently would not have any highly effective treatments,” Dr. D’Amico says.
Source:
Journal reference:
Mahal, B. A., et al. (2023). Mortality Risk for Docetaxel-Treated, High-Grade Prostate Cancer With Low PSA Levels: A Meta-Evaluation. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2023.40787.