Population-based impact on overall survival after the introduction of docetaxel as standard therapy for metastatic castration resistant prostate cancer

Authors

  • Robert R. Zielinski
  • Arun A. Azad
  • Kim N. Chi
  • Scott Tyldesley Vancouver Centre, British Columbia Cancer Agency

DOI:

https://doi.org/10.5489/cuaj.2076

Keywords:

docetaxel, survival, castration resistant prostate cancer, retrospective study, chemotherapy

Abstract

Introduction: Utilization of docetaxel in patients with metastatic castration resistant prostate cancer (mCRPC) remains low despite its demonstrated survival benefit. In a population-based cohort, we sought to determine whether the introduction of docetaxel has improved overall survival (OS).

Methods: A retrospective review was conducted of mCRPC patients treated with palliative radiotherapy to bone in British Columbia, Canada. Patients in the pre-docetaxel era (pre-DOC, prior to general availability of docetaxel for CRPC) received radiotherapy to bone (RT-B) from 1998 to 2001 and those in the docetaxel era (DOC) received radiotherapy from 2006 to 2009. Time of first radiotherapy to bone was used to select patients at a similar point in their disease state (i.e., onset of bone pain). The primary objective was to determine median OS in the two eras.

Results: Of the 919 patients in the pre-DOC era and the 957 in the DOC era, 7% and 37% received docetaxel, respectively. The median OS from time of first palliative RT was 7.5 months versus 10.3 months (hazard ratio [HR]: 0.79, 95% confidence interval [CI] 0.72–0.87; p < 0.0001) in the pre-DOC and DOC cohorts, respectively. On multivariable analyses, both eras treated (HR 0.84; p = 0.001) and the receipt of docetaxel (HR 0.78; p < 0.001) were significantly associated with OS.

Conclusion: Although docetaxel penetrance was <50%, median OS was significantly improved in the DOC era compared to the pre-DOC era. This is the first study to demonstrate that docetaxel improves OS in mCRPC patients at a population level.

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Published

2014-08-11

How to Cite

Zielinski, R. R., Azad, A. A., Chi, K. N., & Tyldesley, S. (2014). Population-based impact on overall survival after the introduction of docetaxel as standard therapy for metastatic castration resistant prostate cancer. Canadian Urological Association Journal, 8(7-8), e520–3. https://doi.org/10.5489/cuaj.2076

Issue

Section

Original Research