• Vol. 46 No. 5
  • 15 May 2017

Outcomes of Dose-Attenuated Docetaxel in Asian Patients with Castrate-Resistant Prostate Cancer



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High levels of toxicities have been observed when docetaxel is administered at the standard dose of 75 mg/m2 every 3 weeks (Q3W) in the real-world treatment of Asian patients with metastatic castrate-resistant prostate cancer (CRPC). This study aimed to evaluate the efficacy and tolerability of 2 attenuated regimens more widely used in an Asian setting to minimise toxicity – 60 mg/m2 Q3W and weekly docetaxel (20 mg/m2 to 35 mg/m2). Materials and Methods: Medical records of 89 CRPC patients between December 2003 and April 2013 were reviewed. Pairwise statistical analysis was performed, comparing efficacy and safety outcomes of 75 mg/m2 Q3W and weekly docetaxel with 60 mg/m2 Q3W. Treatment endpoints used were prostate-specific antigen (PSA) response (decrease of ≥50% from baseline), pain improvement after cycle 2, overall survival, time to disease progression and radiological response. Results: Patients who received docetaxel at 75 mg/m2 Q3W were younger than those who received 60 mg/m2 Q3W (62 years and 66 years, respectively; P = 0.0489). Both groups had similar response rates. Compared with patients on 60 mg/m2 Q3W, more patients on weekly regimens were symptomatic at baseline (63.2% and 87.5%, respectively; P = 0.0173). Longer overall survival was observed in the 60 mg/m2 Q3W arm than the weekly docetaxel arm (16.9 months and 10.6 months, respectively; P = 0.0131), though other measures of response did not differ significantly. Conclusion: Our data supports the use of 60 mg/m2 Q3W docetaxel which has similar efficacy and an acceptable toxicity profile compared to the standard 75 mg/m2 Q3W regimen. Weekly docetaxel has significant palliative benefits among symptomatic patients despite lower overall survival.

The incidence of prostate cancer is rising in Asia. In Singapore, prostate cancer is the third most prevalent cancer among males, with an age-standardised rate of 28.0 per 100,000 a year from 2007 to 2011.

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