288P - Castration-resistant prostate cancer: Results of chemotherapy treatment in the real life practice

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Prostate Cancer
Presenter Chanyoot Bandidwattanawong
Citation Annals of Oncology (2016) 27 (suppl_9): ix90-ix93. 10.1093/annonc/mdw584
Authors C. Bandidwattanawong1, K. Pornchaichanakit2
  • 1Medical Oncology Unit, Department Of Internal Medicine, Bangkok Metropolitan Administration Medical School and Vajira Hospital, 10300 - Bangkok/TH
  • 2Internal Medicine, Bangkok Metropolitan Administration Medical School and Vajira Hospital, 10300 - Bangkok/TH

Abstract

Background

Thailand will be an aging society soon. More and more castration-resistant prostate cancer (CRPC) cases have been diagnosed. When TAX 327 study was published in 2004, the docetaxel/prednisolone regimen has been the standard treatment. However, the Thai Government has allowed re-imbursement for every patients since 2011. We still do not know what the outcomes are in the real-life setting.

Methods

Data from written and electronic medical records of patients with CRPC diagnosed at Vajira Hospital from January 1, 2011 to December 31, 2015 were retrospectively extracted and analysed. Baseline characteristics included ages and PS at diagnosis and when CRPC developed, Gleason score at diagnosis, patterns of treatments at earlier stages and when CRPC developed and PSA when CRPC developed and subsequently after treatments of CRPC. Primary endpint was to determine the overall survival (OS). Secondary endpoints were to find out treatment tolerability, PSA response rate based on PSWG criteria and independent prognostic factors of survival benefit. We compared our results with the original TAX 327's.

Results

There were 41 CRPC cases in our cohorts. At the diagnosis of CRPC, the median age (95% CI) was 74 (66-76) and median PSA level was 127 (71-225). All of them had bone metastasis. Twenty one of them had documented Gleason score and the median was 8. Thirty seven of them had PS 0-2 and were treated with the docetaxel/prednisolone regimen. Thirty two of the 37 patients could tolerate the recommended dose. The median cycles of treatment was 8. PSA response rates were 67.7% PR, 22.6% SD and 9.7% PD. Median survival was 15 (8–21) months. Compared with TAX 327, we found that our patients were older with higher risks (higher Gleason score at diagnosis and higher PSA level when CRPC developed). PSA response was the only prognostic factor of survival.

Conclusions

In the real-life practice, CRPC cases are more severe and debilitated. The docetaxel/prednisolone regimen is tolerated in well selected cases even at extreme ages. We advocate that PCWG PSA response criteria should be used. To optimize cost and benefit, a medical oncologist should discontinue the chemotherapy, if no PSA response is observed after 3-4 cycles.

Clinical trial indentification

COA 63/2559

Legal entity responsible for the study

Research Facilitation Division, Faculty of Medicine Vajira Hospital

Funding

Research Facilitation Division, Faculty of Medicine Vajira Hospital

Disclosure

All authors have declared no conflicts of interest.