Docetaxel timing in CRPC patients who had a poor response on ADT.

[pjoshea13]

Interesting new paper from Japan.

"We identified 148 mCRPC patients who were treated with 75 mg/m2 docetaxel. We defined 16 months as the threshold for the effective duration of ADT, and defined 12 months as the cut-off time for starting docetaxel from the onset of CRPC."

"The median ... ADT response was 22.2 months and the median time interval from CRPC onset to docetaxel treatment was 11.7 months."

For those who failed ADT in under 16 months, there was a far better prognosis if Docetaxel was started early (<12 months).

"... 1-year and 2-year {cancer-specific survival} rates were 96.0% and 80.0% in the patients who introduced docetaxel in early setting (< 12 months), which were significantly higher than those who introduced in late settings (93.6% and 30.8%, respectively ..."

-Patrick

ncbi.nlm.nih.gov/pubmed/306...

Int J Clin Oncol. 2019 Jan 2. doi: 10.1007/s10147-018-01388-5. [Epub ahead of print]

Castration-resistant prostate cancer patients who had poor response on first androgen deprivation therapy would obtain certain clinical benefit from early docetaxel administration.

Shigeta K1, Kosaka T2, Hongo H1, Yanai Y1, Matsumoto K1, Morita S1, Mizuno R1, Shinojima T1, Kikuchi E1, Oya M1.

Author information

1

Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

2

Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. [e-mail].

Abstract

BACKGROUND:

Our specific aim was to investigate the prognostic value of effective duration of first androgen deprivation therapy (ADT) and to evaluate the clinical impact on early docetaxel administration with oncological outcomes in castration-resistant prostate cancer (CRPC) patients treated with docetaxel.

METHODS:

We identified 148 mCRPC patients who were treated with 75 mg/m2 docetaxel. We defined 16 months as the threshold for the effective duration of ADT, and defined 12 months as the cut-off time for starting docetaxel from the onset of CRPC. Univariate and multivariate analyses were conducted to investigate the prognostic indicators that influenced the survival outcomes.

RESULTS:

Overall, 81 (54.7%) patients died. The median 1st ADT response was 22.2 months and the median time interval from CRPC onset to docetaxel treatment was 11.7 months. Multivariate analysis indicated that visceral metastasis, bone metastasis extent of disease (EOD) ≥ 2, and effective duration of ADT < 16 months were the independent prognostic indicators for progression-free survival (PFS). Referring to cancer-specific survival (CSS), besides visceral metastasis and effective duration of ADT < 16 months, late docetaxel treatment ≥ 12 months became as the predictors for poor prognosis. Among the ADT poor-responder group (ADT < 16 months), Kaplan-Meier method showed that 1-year and 2-year CSS rates were 96.0% and 80.0% in the patients who introduced docetaxel in early setting (< 12 months), which were significantly higher than those who introduced in late settings (93.6% and 30.8%, respectively, p < 0.001).

CONCLUSION:

CRPC patients who had poor response during 1st ADT would obtain survival benefit by introducing docetaxel treatment in early stage.

KEYWORDS:

Androgen deprivation therapy; Docetaxel; Metastatic castration-resistant prostate cancer

PMID: 30604159 DOI: 10.1007/s10147-018-01388-5

[NPfisherman]

Thanks, Patrick....solid information .... Are you following MM310--a version of docetaxol with a liposomal attachment....supposed to be more tumor specific....unsure why some form of docetaxol with monosaccharide attachment has never been tried or developed...with cancer having such a high affinity for sugar....

[pjoshea13 in reply to NPfisherman]

NP,

I tend to wait for papers to appear on PubMed.

Years ago, I simply refused to read about taxanes. The treatment of last resort. That's all changed, of course. But I hope I can get through 2019 without needing one.

-Patrick

[NPfisherman in reply to pjoshea13]

Patrick,

I hope you wouldn't need that either....taxanes are so random and their side effects are most unpleasant...they do kill tumor cells...if they could be less random and more tumor specific, then intuitively, one would think that a decrease in the side effects would occur since a much higher concentration would be in tumor cells, and less in normal cells...that's why I follow MM310--hoping I will not need anything like that for a long time, but a better version would be a great improvement for all.

[NPfisherman]

I might think that big pharma might be involved... I did some reading and it is used for a variety of things chemically, as you well know. Could it be used as a catalyst to drive binding taxanes to monosaccharides, orsome sugar molecule form ? It would take someone like you (Mr Chemist) to know for sure...Thanks for your response...

All the best,

Fish

[NPfisherman]

Government and Big Pharma.... money talks and people die.... their empathy for suffering cancer patients is just overwhelming.....

[podsart]

DSMO =?

[pjoshea13 in reply to podsart]

rxlist.com/dmso_dimethylsul...

[podsart in reply to pjoshea13]

Thanks

[podsart]

Yes, thanks