Docetaxel versus Abiraterone in Newly Diagnosed Metastatic Prostate Cancer : Study from Tertiary Care Cancer Centre in a Developing Country

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer Care Delivery in Low Resource Environments
Prostate Cancer
Presenter Shaik Hussain
Citation Annals of Oncology (2018) 29 (suppl_9): ix67-ix73. 10.1093/annonc/mdy434
Authors S.M. Hussain, G. Gautam, P. Ahluwalia, A. Punnakal, H. Chaturvedi, A. Gupta
  • Medical Oncology, Max Institute of Cancer Care, 110024 - New Delhi/IN

Abstract

Background

Docetaxel or Abiraterone (AA) combined with androgen deprivation therapy (ADT) achieves superior overall survival in newly diagnosed metastatic prostate cancer (mCNPC) compared to ADT alone. We sought to compare Docetaxel with AA in our patient population.

Methods

33 patients with mCNPC who received either docetaxel or AA along with ADT between May 2016 and December 2017 were included. Histological diagnosis was established by TRUS guided prostate biopsy and staging was done by 68Ga-PSMA PET/CT scan in all patients. Twenty-two patients received docetaxel 50 mg/m2 every 2 weekly for 10 doses and 11 patients received AA 1000 mg per oral daily along with ADT (30 medical and 3 surgical) . Patients were monitored every 2 weekly for clinical and biochemical adverse events (CTCAE 4.0). Treatment responses were evaluated clinically and serologically (serum PSA every 4-weekly).

Results

Clinical, histological and radiological characteristics were comparable between the two groups (Table). All patients achieved PSA response with a median time to PSA response of 1 month in both groups. This compares well with LATITUDE study which reported 91% PSA response in AA arm. Nine (41%) patients in docetaxel group and 5 (45%) patients in AA group achieved serological complete response (PSA<0.2ng/ml) with a median time of 5 months and 4 months, respectively. This compares well with 32% reported in docetaxel arm of CHAARTED trial. Paronychia (2 patients) was the only grade 3 event reported in docetaxel group and none in AA group. One patient in docetaxel group died of pneumonia. At a median follow up of 16 months in docetaxel group and 8 months in AA group, 6 (27%) patients and none have progressed to CRPC, respectively.Table: 225P

CharacteristicDocetaxel + ADT (N = 22)Abiraterone + ADT (N = 11)
Median Age (years)6466
Gleason score
761
8-101610
MedianPSA (ng/ml) (Range)105 (3.8-4000)46 (11-1560)
Bone metastasis (%)21 (95)11 (100)
Lymph node metastasis (%)21 (95)9 (82)
Visceral metastasis (%)7 (32)2 (18)
Achieved PSA response* at 1 month (%)22 (100)11 (100)
Median time to Nadir PSA (Month)54
Achieved Serological CR# (%)9 (41)5 (45)
Median time for Serological CR (Month)54
Median Follow up (Month)168
Progressed to CRPC (%)6 (27)0
*

PSA response: decrease of at least 50% from the baseline value

#Complete serologic response: PSA level of less than 0.2 ng/ml

Conclusions

Within the limitations of a small retrospective study, we conclude that both docetaxel and abiraterone are well tolerated and are associated with comparable short term treatment outcomes (Serological CR) in metastatic CNPC patients.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Max Institute of Cancer Care.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.