Docetaxel may improve outcomes in well-selected high-risk non-metastatic HSPC patients
Piotr J. Wysocki
MD, PhD, medical oncologist; Professor of Medicine, Head of Department of Oncology, Jagiellonian University Hospital. ASCO International Affairs Committee member
A recent meta-analysis published in JAMA Network Open suggests clinically meaningful benefit of docetaxel in high-risk, M0 HSPC patients following radical radiotherapy combined with ADT or radical prostatectomy [1]. The study analyzed patients from 5 randomized clinical trials, who fulfilled following criteria - PSA<4 ng/ml and tumor grading group (GG 4-5; Gleason score 8-10). A few cycles of docetaxel improved PCSM (prostate cancer-specific mortality) HR=0.51 and all-cause mortality HR=0.42 in patients in good and very good performance status (ECOG 0-1).
This analysis provides a valuable information for clinical practice: in high risk, non-metastatic HSPC patients (ECOG 0-1) with low PSA (<4 ng/ml) and agressive tumor biology (especially GG5), in whom standard adjuvant ADT is not active [2] - docetaxel may represent a unique opportunity to improve their survival.
Lead Clinical Oncologist at Garissa Regional Cancer Center|Cancer Research Fellow & Health Service Researcher at Queen's University Canada ????|Clinical Trials Enthusiast| Cancer Care Equity Advocate||
1 年Interesting data. Would be interesting to see the uptake of chemo drug albeit single agent post radical treatment in such patients. Am guessing mostly younger and fit patients might accept while also not forgetting keeping docetaxol role in later lines especially in high volume disease James Mbogo Abeid M. Athman Omar Dr. Peter Mulatya