Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer

By C. Sweeney, Yu‐Hui Chen, M. Carducci, Glenn Liu, D. Jarrard, M. Eisenberger, Y. Wong, N. Hahn, M. Kohli, M. Cooney and 7 more. New England Journal of Medicine, 2015

2,587 citations recorded by the source corpus.

BACKGROUND Androgen-deprivation therapy (ADT) has been the backbone of treatment for metastatic prostate cancer since the 1940s. We assessed whether concomitant treatment with ADT plus docetaxel would result in longer overall survival than that with ADT alone. METHODS We assigned men with metastatic, hormone-sensitive prostate cancer to receive either ADT plus docetaxel (at a dose of 75 mg per square meter of body-surface area every 3 weeks for six cycles) or ADT alone. The primary objective was to test the hypothesis that the median overall survival would be 33.3% longer among patients receiving docetaxel added to ADT early during therapy than among patients receiving ADT alone. RESULTS A total of 790 patients (median age, 63 years) underwent randomization. After a median follow-up of 28.9 months, the median overall survival was 13.6 months longer with ADT plus docetaxel (combination therapy) than with ADT alone (57.6 months vs. 44.0 months; hazard ratio for death in the combination group, 0.61; 95% confidence interval [CI], 0.47 to 0.80; P<0.001). The median time to biochemical, symptomatic, or radiographic progression was 20.2 months in the combination group, as compared with 11.7 months in the ADT-alone group (hazard ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). The rate of a prostate-specific antigen level of less than 0.2 ng per milliliter at 12 months was 27.7% in the combination group versus 16.8% in the ADT-alone group (P<0.001). In the combination group, the rate of grade 3 or 4 febrile neutropenia was 6.2%, the rate of grade 3 or 4 infection with neutropenia was 2.3%, and the rate of grade 3 sensory neuropathy and of grade 3 motor neuropathy was 0.5%. CONCLUSIONS Six cycles of docetaxel at the beginning of ADT for metastatic prostate cancer resulted in significantly longer overall survival than that with ADT alone. (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00309985.)

Subfields: Oncology, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/fc515acf5aa337a6981464bffb34f7201563815f

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In Oncology

1. Michel Bolla
2. N. Mottet
3. J. Bellmunt
4. M. Hallek
5. Steven Joniau
6. Thomas Wiegel

In Pulmonary and Respiratory Medicine

1. M. Hallek
2. Michel Bolla
3. N. Mottet
4. J. Bellmunt
5. Steven Joniau
6. Thomas Wiegel

Citations in the corpus

• EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part II: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer. (2017, methodology): “In the CHAARTED trial [60], the same inclusion criteria applied, although patients were stratified according to disease volume; high volume was defined as either presence of visceral metastases or four or more bone metastases, with at least one outside the spine and pelvis.”
• Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial. (2018, methodology): “We previously reported a survival benefit with the addition of docetaxel at an interim evaluation of the CHAARTED study.(3) The survival benefit was noted for the study population as a whole (HR for death, 0.”
• Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer. (2019, neutral): “Chest pain from cardiac cause 3 (1) 2 (<1)”
• ARCHES: A Randomized, Phase III Study of Androgen Deprivation Therapy With Enzalutamide or Placebo in Men With Metastatic Hormone-Sensitive Prostate Cancer (2019, background): “gov identifier: NCT00309985) criteria.(6) Treatment continued until occurrence of unacceptable toxicity, radiographic progression (confirmed by independent central review), or initiation of an investigational agent or new prostate cancer therapy.”
• Abiraterone plus Prednisone in Metastatic, Castration‐Sensitive Prostate Cancer (2017, background): “Adverse event leading to death 28 (5) 24 (4)”
• Towards precision oncology in advanced prostate cancer (2019, neutral): “A , androgen; ABI, abiraterone; AKTi, AKT inhibitor ; FKBP5, FK506 binding protein 5; PHLPP, PH domain leucine- rich repeat protein phosphatase; PtdIns(4,5)P2, phosphatidylinositol 4,5-bisphosphate; PtdIns(3,4,5)P3, phosphatidylinositol 3,4,5-trisphosphate; RTK , receptor tyrosine kinase.”
• Prostate Cancer (2018, background): “At a minimum, bladder scan and flow rate characteristics coupled with cystoscopy provide data to guide the decision for downsizing [6, 7].”