Adjuvant Weekly Docetaxel For Patients With High Risk Prostate Cancer After Radical Prostatectomy: A Multi-Institutional Pilot Study

Main Category: Prostate / Prostate Cancer
Also Included In: Men's health;  Urology / Nephrology;  Clinical Trials / Drug Trials
Article Date: 14 May 2007 - 0:00 PDT

email to a friend   printer friendly   opinions  

UroToday.com- Docetaxel chemotherapy is shown to improve survival in patients with androgen-insensitive prostate cancer (CaP). In the May, 2007 issue of the Journal of Urology, Dr. Adam Kibel and collaborators report a pilot study on adjuvant docetaxel in post radical prostatectomy (RP) CaP patients at high-risk for disease progression.

A total of 77 patients were prospectively enrolled between 2002 and 2004. Surgical pathology was centrally reviewed and patient risk for recurrence was at least 50% at 3 years based upon a validated model. Post-RP, patients could have a detectable PSA, but no radiographic evidence of distant disease. These patients then received 6 cycles of docetaxel on days 1, 8, and 15 of each 28-day cycle.

Median follow-up was 29.2 months and only 1.3% had pT2Nx disease, although 74% were clinically staged as cT1-2. Pathologically, 99% had non-organ confined disease, 56% had Gleason score 8-10, 65% had positive surgical margins, 65% had seminal vesicle involvement and 38% had lymph node involvement.

Docetaxel therapy resulted in Grade I/II in 70%, Grade III in 26%, and Grade IV in 4%. By the end of 2005, 7 of 76 men (9%) had died with 4 deaths due to CaP. Disease progression at 29 months occurred in 61%. One and two-year progression-free survival (PFS) was 63% and 42%, respectively. Median PFS was 16 months, while predicted PFS was 10 months. Patients who had an undetectable PSA at the initiation of docetaxel had lower evidence of progression.

The outcome of this cohort of CaP patients is heavily influenced by their very high-risk features and not getting the now documented docetaxel regimen every 3 weeks. Further randomized trials will continue to provide insight into this treatment paradigm.

Kibel AS, Rosenbaum E, Kattan MW, Picus J, Dreicer R, Klein EA, Chatta GS, Nelson JB, DiPaola RS, Roth BJ, Cookson MS, Wilding G, Jarrard DF, Beer TM, Ryan CW, Petrylak DP, Benson MC, Partin AW, Garrett-Mayer E, Eisenberger MA

J Urol 2007; 177(5):1777-81 Reviewed by UroToday.com Contributing Editor Christopher P. Evans, MD

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2006 - UroToday

• Additional
• References
• Citations