(UroToday.com) The 2022 ASCO annual meeting featured a session on prostate cancer, including a presentation by Dr. Abhishek Tripathi discussing 8-year survival rates by baseline prognostic groups in patients with mHSPC from the CHAARTED trial. Treatment intensification with docetaxel improves overall survival (OS) in mHSPC when added to testosterone suppression. To date there is no prospective survival data beyond 5 years for patients treated with ADT with or without docetaxel when analyzed by well-defined baseline prognostic risk groups and treatment arms. In this updated analysis of the CHAARTED trial.1,2 Dr. Tripathi and colleagues report the 8-year survival rate based on disease volume and metachronous versus de novo metastatic disease status with ADT without or with docetaxel.
An updated survival analysis was conducted in February 2022. Patients were prospectively identified by the state of metastatic disease as metachronous (prior local therapy) versus de novo and low volume versus high volume (visceral and/or ≥4 bone metastases with one lesion beyond the vertebral bodies or pelvis) disease. OS was defined as time from randomization to death or date last known alive and calculated using the Kaplan-Meier method.
Of the 790 patients randomized (last patient enrolled December 2012), 238 patients were still alive with a median follow up of 9.7 years for patients still alive. Median OS in the overall population was 60.4 and 47.2 months in the ADT + docetaxel and ADT arms respectively (HR 0.77, 95% CI 0.65, 0.92; p=0.004):
ADT + docetaxel was associated with significantly higher 8-year OS rate (28.5%) compared to ADT arm (15.4%; HR 0.67, 95% CI 0.53, 0.84; p=0.0005) in the de novo high volume group (n=421). Notably, the 8-year OS rates were almost doubled for patients with high volume disease with early docetaxel (16% vs. 30.2%, p<.0001) and this was seen in patients with both de novo and metachronous high volume mHSPC. As follows is the Kaplan-Meier curves for (a) de novo high-volume disease, (b) de novo low volume disease, (c) metachronous high volume disease, and (d) metachronous low volume disease.
Dr. Tripathi concluded this presentation discussing 8-year survival rates by baseline prognostic groups in patients with mHSPC from the CHAARTED trial with the following summary points:
- In this long-term updated analysis, ADT + docetaxel continued to demonstrate significantly improved OS in the overall population and this is still most clearly evident in patients with de novo high volume mHSPC
- These findings highlight the role of baseline prognostic risk groups in predicting longer term survival and benefits from treatment intensification
Presented by: Abhishek Tripathi, MD, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, Chicago, IL, Fri, June 3 – Mon, June 7, 2022.
- Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer. N Engl J Med. 2015;373(8):737-746.
- Kyriakopoulos CE, Chen YH, Carducci MA, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: Long-term survival analysis of the randomized phase III E3805 CHAARTED trial. J Clin Oncol 2018 Apr 10;36(11):1080-1087.