The following is a summary of “Efficacy And Feasibility Of Additional Cycles Of Docetaxel In Combination With Androgen Deprivation Therapy In Metastatic Hormone-Sensitive Prostate Cancer,” published in the April 2023 issue of Urology by Aydogdu et al.

Several phase III trials have established the standard treatment for a subgroup of metastatic hormone-sensitive prostate cancer (mHSPC) patients as 6 cycles of docetaxel combined with androgen deprivation therapy (D-ADT). To explore whether extending treatment beyond this standard improves efficacy, researchers conducted a retrospective analysis at a major tertiary care center, gathering data from patients diagnosed with histologically confirmed adenocarcinoma of the prostate and radiologically confirmed metastatic disease. All patients received D-ADT as first-line therapy, and a subset received more than the standard 6 cycles of docetaxel. The investigators evaluated clinical and pathological variables, treatment-related toxicities, progression-free survival on D-ADT (PFS1), progression-free survival on subsequent therapy (PFS2), and overall survival (OS) from the start of treatment until progression or death. From 2018 to 2022, 88 mHSPC patients were observed for a median of 11.9 months. Among them, 56 patients received 6 or fewer cycles of docetaxel (D-ADTstand), while 32 received more than 6 cycles (D-ADTadd). 

Toxicity rates were comparable between the groups. However, no significant differences were observed in median PFS1 (14.0 vs. 13.7 months) or PFS2 (5.5 vs. 8.9 months). The median OS for the D-ADTstand group was 39.9 months, while the OS for the D-ADTstand group has yet to be reached. Although the feasibility of administering more than 6 cycles of D-ADT without considerable additional toxicity was confirmed, their findings did not demonstrate superior efficacy compared to the standard 6-cycle treatment. As OS data is still developing, the potential benefit of increased upfront chemotherapy is questionable and warrants further investigation, especially considering emerging triplet combinations in mHSPC, which may replace the doublet D-ADT.

Source: auajournals.org/doi/10.1097/JU.0000000000003257.17