This study investigated real-world patterns of docetaxel use for metastatic castration-resistant prostate cancer (mCRPC) in China.
A prospective, multi-centre, observational study of Chinese adults (≥18 years) with histologically confirmed metastatic prostate adenocarcinoma who received ≥1 dose of docetaxel following hormonal therapy failure (disease progression and serum testosterone
From August 2011 to June 2016, 403 patients were enrolled at 32 centres and 315 (78.2%) completed the study. The mean number of docetaxel cycles and dose were 4.4 (2.86) and 66.9 mg/m2 (9.12), and treatment compliance was 94.0% (10.94%). mOS was similar for docetaxel after 1st- or 2nd-line hormonal therapy (Table), and was longer in patients without visceral metastases versus those with visceral metastases (23.3 months vs. 17.4 months, P = 0.019). Planned docetaxel treatment was completed by 30.8% (124) of patients; the most common reasons for discontinuation were ‘other reasons’ (23.3% ), cost of medical expenses (22.6% ), and tumor progression (14.1% ). Treatment-emergent AEs (TEAEs) occurred in 20.8% (84), and serious TEAEs in 4% (16), of patients.Table:
|Pattern of use of docetaxel in Chinese patients with mCRPC||n (%)||Median overall survival, months (95% CI)||PSA response rate, % (n/na)|
|All patients||403 (100)||22.4 (20.4, 25.8)||70.9 (168/237)|
|After failure of 1st-line hormonal therapy||170 (42.2)||22.5 (19.2, 29.5)b||73.6 (64/87)|
|After failure of 2nd-line hormonal therapy||125 (31.0)||23.3 (18.1, 26.5)b||67.1 (55/82)|
|After failure of ≥ 3rd-line hormonal therapy||51 (12.7)||22.4 (19.0, 36.5)||65.4 (17/26)|
|After failure of estramustine therapy||46 (11.4)||20.2 (16.6, 27.7)||69.7 (23/33)|
|Other||11 (2.7)||28.6 (17.5, not evaluable)||100.0 (9/9)|
Denominator is the number of patients in each category who had PSA ≥20 ng/ml at baseline;b
p = 0.781 for median overall survival with initiation of docetaxel following failure of 1st- and 2nd-line hormonal therapy. mCRPC, metastatic castration-resistant prostate cancer; PSA, prostate specific antigen.
Around three-quarters of Chinese mCRPC patients treated with docetaxel initiate treatment after failure of 1st- or 2nd-line hormonal therapy and mOS and PSA RR are similar in both settings. Docetaxel was relatively well tolerated.
Clinical trial identification
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All authors have declared no conflicts of interest.