Docetaxel rechallenge in mPCa. - Advanced Prostate...

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Docetaxel rechallenge in mPCa.

4 years ago•4 Replies

New Korean study below [1].

"Overall, 30%, 44%, 13%, and 13% of patients received docetaxel rechallenge as either the third, fourth, fifth, or sixth-line therapy, respectively, at a median of 23.6 months after stopping first-line docetaxel.

"With first-line docetaxel and rechallenge, median treatment duration was 6.4 and 3.3 months, respectively.

"With docetaxel rechallenge, PSA response was 35% ... and median PFS {progression-free survival} was 4.5 months ...

"The median OS {overall survival} was 24.3 months ..."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/329...

Investig Clin Urol

. 2020 Sep 8. doi: 10.4111/icu.20200214. Online ahead of print.

Docetaxel rechallenge in metastatic castration-resistant prostate cancer: A retrospective, single-center study

Seonggyu Byeon 1 2 , Hyera Kim 1 , Jinchul Kim 1 , Minsuk Kwon 1 , Joon Young Hur 1 , Hwang Gyun Jeon 3 , Seong Soo Jeon 3 , Hyun Moo Lee 3 , Se Hoon Park 4

Affiliations expand

PMID: 32985144 DOI: 10.4111/icu.20200214

Free article

Abstract

Purpose: To assess the efficacy and safety of docetaxel rechallenge in the salvage setting in metastatic castration-resistant prostate cancer (mCRPC) patients.

Materials and methods: Clinicopathologic data from patients treated with docetaxel rechallenge were collected from a single-center cancer registry. Among 227 patients who received first-line docetaxel for mCRPC between January 2011 and June 2019, 23 undergo rechallenge docetaxel after failure to androgen receptor targeting agents and/or cabazitaxel treatment. Endpoints included radiologic progression-free survival (PFS), treatment duration, and prostate-specific antigen (PSA) response and safety.

Results: Overall, 30%, 44%, 13%, and 13% of patients received docetaxel rechallenge as either the third, fourth, fifth, or sixth-line therapy, respectively, at a median of 23.6 months after stopping first-line docetaxel. With first-line docetaxel and rechallenge, median treatment duration was 6.4 and 3.3 months, respectively. With docetaxel rechallenge, PSA response was 35% (95% confidence interval [CI], 15% to 54%) and median PFS was 4.5 months (95% CI, 1.9 to 7.1 months). The median OS was 24.3 months (95% CI, 4.6 to 44.0 months). There were 7 severe adverse events (grade 3 or more) including anemia (8.7%), neutropenia, thrombocytopenia, leukopenia, diarrhea, and nausea (4.3% each).

Conclusions: Docetaxel rechallenge showed meaningful anti-tumor activity with acceptable toxicity in heavily pretreated patients with mCRPC.

Keywords: Chemotherapy; Docetaxel; Prostate cancer.

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pjoshea13

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4 Replies

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4 years ago

I had an interesting discussion with my oncologist on this subject. I told him I would be interested in rechallenging Docetaxel after my current treatment Zytiga becomes ineffective.

He looked at how fast my PSA rose after stopping Docetaxel to determine whether he thought it was effective and as he put it "go back to the well". He said that since my PSA rose after only 4 months, we shouldn't go back to Docetaxel but move on to second-line Cabazitaxel.

Just thought I'd pass along that conversation. I was surprised and hadn't considered that before then, but I do think my doctor is right.

in reply to 4 years ago

I agree with your oncologist. It's the sequence my MO and myself have decided to take when the time comes, followed by a rechallenge with Zytiga.

in reply to 4 years ago

That's great. So far, I haven't been able to get my Oncologist to agree with the Zytiga rechallenge after chemo although I have a backup plan for that. I have enough Zytiga to do my own rechallenge for quite a while if I want to. I may also try something else after chemo, like Darolutamide if I can get that. I do think the chances are better with a different anti-androgen.