Treatment With Docetaxel Reduced Risk of Death in Prostate Cancer

Patients with prostate cancer receiving docetaxel with the treatment of radiation and androgen deprivation therapy (ADT) or radical prostatectomy (RP) may have a reduced risk of death and a better prognosis, according to findings from a recent study.

People with localized or locally advanced nonmetastatic, high-grade prostate cancer and low prostate-specific antigen (PSA) levels who received the chemotherapy drug, docetaxel, with radiation and ADT had a 70% reduction in death from prostate cancer-specific mortality (PCSM), according to a study published in JAMA Network Open. These respective patients were in otherwise good health and had a Gleason score from eight to 10.

A Gleason score is used to create treatment plans and determine prognoses for patients with prostate cancer, according to National Cancer Institute, and ranges from six to 10. Higher Gleason scores mean the cancer cells are more likely to grow and spread faster than cancer cells with lower Gleason scores.

The American Cancer Society estimated that in 2023, there will be approximately 288,300 new cases of prostate cancer, with about 34,700 prostate cancer-related deaths. In American men, it is also reported by the American Cancer Society that prostate cancer is the second leading cause of death next to lung cancer.

In the study from JAMA Network Open, there were 145 total patients who had high-grade prostate cancer with low PSA levels. The median age was 63 years, all identified as men and the majority identified as White (81.4%).

Types of treatment given in the study included radical prostatectomy (surgical removal of entire prostate and surrounding tissue with nearby lymph nodes) alone or radiotherapy plus ADT in the standard-of-care (SOC) group of 67 patients. The other group had 78 patients who received docetaxel plus SOC as treatment.

The study’s two primary endpoints, or main results measured at the end of a study to identify the effectiveness of treatment, were all-cause mortality and PCSM. According to the study, all-cause mortality was recorded from the date when patients were randomly assigned to cohorts until death from any cause.

“Of these 145 patients, 139 had excellent performance status and were the main focus of the study. An excellent PS identifies patients who can tolerate the full course of chemotherapy and therefore benefit if the treatment proves effective,” Dr. Anthony Victor D’Amico, chief of genitourinary radiation oncology at Brigham and Women’s Hospital in Boston and senior author of the study, said in a news release.

Based on the results of the study, at a median follow-up was 7.1 years, the researchers found that 31 patients died, with 19 deaths among the SOC group and 12 deaths in the SOC plus docetaxel group. They also reported that 22 of the deaths were related to prostate cancer (15 patients from the SOC group and seven from the SOC plus docetaxel group).

Regarding all-cause mortality and PCSM in this patient population, the results from the study determined that a “reduced but nonsignificant risk” of all-cause mortality and PCSM corresponded with the patients in the SOC plus docetaxel group when compared with the SOC group.

“It’s a marked improvement in survival for these patients, who currently do not have any highly effective treatments,” D’Amico said in the news release.

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