BERKELEY, CA (UroToday.com) - The TAX 327 study was reported in 2004 and evaluated patients with hormone-refractory prostate cancer (HRPC) in three treatment arms; docetaxel 75mg/m2 every 3 weeks (D3P), docetaxel 30mg/ m2 weekly (D1P), or mitoxantrone 12 m2 every 3 weeks (MP), each with prednisone 5mg twice daily. It demonstrated significant survival benefit to D3P compared to MP but no significant difference to D1P. D3P also had better palliation. At that report, 557 of 1,006 participants had died. In the January 10, 2008 issue of the Journal of Clinical Oncology Dr. Berthold and colleagues provide an updated report.

For this evaluation, 867 deaths had occurred, 111 had been lost to follow-up, and 28 men were alive. Median survival for the D3P, D1P, and MP arms were 19.2 months, 17.8 months, and 16.3 months, respectively. The percentages of participants surviving 3 years were 18.6%, 16.8, and 13.5%, respectively. The difference between the D3P and MP arms increased to 2.9 months from the previous analysis. The D1P and MP arms remain non-significant.

Subgroup analysis assessed other variables. Similar survival was seen between treatment arms for patients older and younger than median age of 68 years. Similar benefits of D3P compared to MP were noted for patients with a PSA at baseline of greater or less than 115ng/ml. Patients with visceral metastasis died on average 6 months earlier than those without, and this was not better for any treatment arm. Similarly, a better KPS correlated with 8 months longer survival, but no benefit for the D3P treatment group. For minimally symptomatic patients, the survival trend was better for D3P compared with MP. However, men with substantial pain had shorter survival time, and there was no benefit with D3P over MP.

Berthold DR, Pond GR, Soban F, de Wit R, Eisenberger M, Tannock IF

J Clin Oncol. 26(2):242-5, January 2008
doi: 10.1200/JCO.2007.12.4008

PubMed Abstract
PMID: 18182665

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Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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