Abstract 369P
Background
The survival outcome in metastatic hormone sensitive prostate cancer (mHSPC) has changed dramatically after introduction of triplet therapy comprising androgen deprivation therapy (ADT), androgen receptor signaling inhibitors (ARSi) and Docetaxel. However, there was limited representation from the Indian population in landmark clinical trials. Here we share our institutional experiences with triplet therapy in de-novo mHSPC.
Methods
Single institute retrospective chart review study at Tata Medical Center, Kolkata, India between 2021-2024. Data was collected from hospital electronic medical records till June 2024. Patients fulfilling eligibility criteria with triplet therapy (ADT plus Docetaxel plus ARSi) were included in this study. STATA statistical software was used for analysis.
Results
Total of 93 patients with high volume mHSPC disease were analyzed. Median age was 67 years(range 48-78 years). 73 patients(78%) had bone with/without nodal metastasis whereas 20(22%) had visceral with/without bone metastasis. 77 patients(83%) presented with ECOG 0-1. All were adenocarcinoma with 52(56%) having a Gleason score of 8 or above. Baseline prostate specific antigen (PSA) ranged from 1.44 to 10,000ng/ml with a mean PSA of 719.43ng/mL. 27% patients underwent bilateral Orchiectomy while 73% received medical castration. 79(85%) patients received 6-8 cycles of docetaxel in the triplet therapy. ADT plus ARSi was then continued till progression or unacceptable toxicities. After a median follow up of 18 months two years predicted PSA progression free survival(PFS) was 80% and radiological PFS was 84%. No difference in PFS between bone versus visceral metastasis (log rank p 0.16). Optimal PSA response ranged from 0.01 to 724 ng/ml with a mean PSA response of 15 ng/ml. Two years' overall survival rate was 80%. 14(15%) had grade 2 and above adverse effects mainly anemia, neutropenia and hypertension.
Conclusions
This study from Indian cohort showed comparable survival outcomes with acceptable toxicities; as reported in the index trials with triple therapy. It should be offered as first line therapy among eligible patients with mHSPC. Further prospective larger scale studies are required from Indian subcontinent.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.