Gustave Roussy Cancer Campus, Villejuif, France
Pernelle Lavaud , Gwenaelle Gravis , Clemence Legoupil , Florence Joly , Stephane Oudard , Franck Priou , Loic Mourey , Michel Soulie , Igor Latorzeff , Remy Delva , Ivan Krakowski , Brigitte Laguerre , Christine Theodore , Jean Marc Ferrero , Philippe Beuzeboc , Muriel Habibian , Stephanie Foulon , Jean Marie Boher , Gabrielle Tergemina-Clain , Karim Fizazi
Background: Since 2015, docetaxel chemotherapy, combined with ADT, is considered the standard of care in fit men with metastatic hormone-naive prostate cancer (m-HNPC), based on data from three phase III trials (GETUG-AFU 15, CHAARTED, and STAMPEDE). No data are currently available regarding the treatments used beyond progression after upfront ADT and docetaxel. Methods: We retrospectively collected data from patients (pts) participating in the GETUG-AFU 15 phase III trial concerning treatments received beyond progression for castration-resistant disease (CRPC) in both arms (ADT and ADT + docetaxel) including treatment efficacy (measured by a PSA decline > 50%, physician assessment of clinical benefit, and time to events), and toxicity (NCI-CTC grading). Results: Data concerning 164 pts are currently available. The treatments most frequently used and their efficacy are detailed in the Table. Toxicity was mild, with only rare grade 3-4 events (16% with first treatments and 13% with second treatments used for CRPC) and no treatment-related death. Conclusions: In this retrospective analysis, anticancer activity was suggested with androgen receptor axis-targeted agents in patients with metastatic prostate cancer treated upfront with ADT + docetaxel. Rather limited activity was observed following a docetaxel rechallenge in this setting.
Treatment used for CRPC (n = 164 pts) | PSA response (ADT vs ADT+D) | Symptomatic response (ADT vs ADT+D) | Median PFS Months (95%CI) (ADT vs ADT+D) | |
---|---|---|---|---|
First treatment for CRPC | Docetaxel (n = 66) | 15/47 (32%) vs 2/12 (17%) | 11/32 (34%) vs 3/9 (33%) | 6.8 (4.8-9) vs 4.1 (2.9-8.2) |
Bicalutamide (n = 56) | 7/26 (27%) vs 3/24 (13%) | 0/11 (0%) vs 3/19 (16%) | 7.8 (4.1-14.4) vs 7.7 (2.8-8.9) | |
Abiraterone or Enzalutamide (n = 12) | 2/2 vs 6/10 | |||
Second treatment for CRPC | Docetaxel (n = 34) | 10/18 (56%) vs 2/13 (15%) | 4/12 (33%) vs 3/9 (33%) | 4.3 (2.5-8.6) vs 3.5 (1.4-6.8) |
Abiraterone or Enzalutamide (n = 32) | 6/16 (38%) vs 7/10 (70%) | 4/8 vs 2/9 | 7 (1.6-9.5) vs 9 (4.6-24) | |
Mitoxantrone (n = 8) | 0/8 vs 0/5 | |||
Carbo-VP16 (n = 8) | 3/7 vs 1/1 |
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