
DOI . ORG {
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Title[redir]:
Effect of docetaxel added to bicalutamide in Hormone-Naïve non-metastatic prostate cancer with rising PSA, a randomized clinical trial (SPCG-14) | Acta Oncologica
Description:
Background Historically, endocrine therapy was used in a range of scenarios in patients with rising PSA, both as a treatment for locally advanced non-metastatic prostate cancer and PSA recurrence following curative intended therapy. In the present study the objective was to investigate if chemotherapy added to endocrine therapy could improve progression-free survival (PFS). Materials and Methods Patients with hormone-naïve, non-metastatic prostate cancer and rising prostate-specific antigen (PSA), enrolled from Sweden, Denmark, the Netherlands, and Finland, were randomized to long-term bicalutamide (150 mg daily) or plus docetaxel (75 mg/m2, q3w, 8–10 cycles) without prednisone, after stratification for the site, prior local therapy or not, and PSA doubling time. The primary endpoint was 5-year PFS analyzed with a stratified Cox proportional hazards regression model on intention to treat basis. Results Between 2009 and 2018, a total of 348 patients were randomized; 315 patients had PSA relapse after radical treatment, 33 patients had no prior local therapy. Median follow-up was 4.9 years (IQR 4.0–5.1). Adding docetaxel improved PFS (HR 0.68, 95% CI 0.50–0.93; p = 0.015). Docetaxel showed an advantage for patients with PSA relapse after prior local therapy (HR 0.67, 95% CI 0.49–0.94; p = 0.019). One event of neutropenic infection/fever occurred in 27% of the patients receiving docetaxel. Limitations were slow recruitment, lack of enrolling patients without radical local treatment, and too short follow-up for evaluation of overall survival in patients with PSA relapse. Conclusion Docetaxel improved PFS in patients starting bicalutamide due to PSA relapse after local therapy or localized disease without local therapy. Confirmatory studies of the efficacy of docetaxel in the setting of PSA-only relapse in addition to endocrine therapies may be justified if longer follow-up will show increased metastatic-free survival.
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Keywords {🔍}
university, sweden, department, cancer, oncology, psa, policy, gothenburg, patients, docetaxel, acta, oncologica, clinical, therapy, urology, sciences, prostate, institute, umeå, hospital, medical, relapse, local, symposia, submission, bicalutamide, randomized, sahlgrenska, copenhagen, content, articles, nonmetastatic, rising, academy, pfs, download, skip, make, open, review, added, hormonenaïve, trial, centre, denmark, finland, netherlands, endocrine, treatment, survival,
Topics {✒️}
downloads download data submission make neutropenic infection/fever occurred improve progression-free survival main content skip rising prostate-specific antigen acta oncologica erasmus medical centre sweden jan-erik damber submission direct metastatic prostate cancer precision medicine radiotherapy nordic signatures commits quality content european cancer rehabilitation region västra götaland nu hospital group 5-year pfs analyzed offer global reach creative commons cc netherlands göran ahlgren long-term bicalutamide authors andreas josefsson curative intended therapy finland marjaana luukkaa finland paul verhagen sweden ove andrén sweden enrique castellanos sweden mihalj seke sweden anders widmark sweden contact skåne university hospital karolinska university hospital prior local therapy make psa doubling time radiophysics psychosocial oncology sweden erik holmberg denmark sirpa aaltomaa randomized clinical trial sahlgrenska university hospital sweden klaus brasso prostate cancer kuopio university hospital turku university hospital radical local treatment research contributions latest research patients receiving docetaxel 1651-226x published
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