Published online Nov 24, 2021. doi: 10.5306/wjco.v12.i11.1009
Peer-review started: March 23, 2021
First decision: July 27, 2021
Revised: August 9, 2021
Accepted: October 18, 2021
Article in press: October 18, 2021
Published online: November 24, 2021
Randomized phase-III trials indicate that upfront treatment with docetaxel, in addition to androgen deprivation therapy (ADT), improves survival in metastatic castration-sensitive prostate cancer (mCSPC). Less is known about the outcome of such treatment in real-world patients treated outside the frames of a clinical trial.
It is important to assess the outcome and safety of upfront docetaxel and ADT combination therapy following its implementation in real-world patients with mCSPC.
To evaluate the outcome of docetaxel and ADT combination therapy in real-world patients with mCSPC in terms of progression-free survival (PFS), overall survival (OS), and safety.
A multicenter retrospective noninterventional study was performed and included 94 first consecutive real-world patients with mCSPC receiving upfront docetaxel and ADT in the Southeast Health Care Region of Sweden. Univariate and multivariate regression analyses were performed to identify prognostic parameters. Adverse events and unplanned hospitalizations were thoroughly reviewed.
PFS at 12 and 24 mo was 75% and 58%, while OS was 93% and 86% concurrently points, respectively. High baseline PSA levels were associated with worse prognosis in multivariate regression analysis. Twenty-one percent of the patients experienced febrile neutropenia, and 26% had at least one episode of unplanned hospitalization.
The outcome and safety of docetaxel and ADT combination therapy in mCSPC appear similar in real-world and randomized controlled trial populations. This study supports further implementation of this treatment strategy in standard of care.
Future studies must identify clinically useful biomarkers and tools for tailored treatment strategies in patients with mCSPC.