Abstract
Background
Recent clinical trials have demonstrated improved survival of young and fit patients with metastatic hormone sensitive prostate cancer treated with upfront docetaxel chemotherapy. Prostate cancer patients in “real world” are elderly with multiple comorbidities. The efficacy and tolerability of docetaxel in these patients is unknown.
Methodology
We conducted a retrospective observational study of patients with newly diagnosed hormone-sensitive de novo or recurrent (metastatic) prostate cancer (mHSPC) who were treated with upfront docetaxel within three months of starting androgen deprivation therapy at Canberra Region Cancer Centre. We collected demographic and the relevant medical information from the medical records.
Results
There were 38 patients in our study with a median age of 65 years (range 46 -77 years). The median PSA at the start of chemotherapy was 63.5. The sites of metastases included bone (82% of patients), lymph nodes (79%) lung (21%) and liver (8%). 26 patients had de novo disease, 10 patients had recurrent disease, and 2 patients had missing data.
After a median follow up of 28 months, 24 patients were still alive. The 12-month and 24-month survival rates were 84% and 66 % respectively. About 5 patients (13%) experienced grade ≥ 3 toxicities including fatigue, peripheral neuropathy, mucositis, infusion reaction, and palmar plantar erythrodysesthesia.
Conclusion
In this small retrospective study with a short follow up, we found that docetaxel was tolerable in “real world” patients with mHSPC with a low grade ≥ 3 toxicity rate. Longer follow-up is needed to assess efficacy outcomes.