BERKELEY, CA (UroToday.com) - Metastatic adenocarcinoma of the prostate continues to be a major cause of mortality worldwide.
In castration-resistant prostate cancer phase II and lll trials, it has been shown that docetaxel given as frontline chemotherapy, combined with estramustine or prednisone, is superior to mitoxantrone combined with the same agents in terms of overall survival (OS), time to progression (TTP), pain control, and PSA response. Our study has shown that the biweekly administration of a paclitaxel and carboplatin regimen in patients with castration-resistant prostate cancer, pretreated with docetaxel, is an active and well-tolerated regimen. In this study we reported similar results to other prior trials with the same agents. However, there are some issues that should be pointed out.
Firstly, we didn’t use a control arm in this study which probably, theoretically, would have reinforced the results, but the strategy and methodology of this study provided robust evidence of antitumor effect (clinical and biochemical response 26,3 %, stable disease 34,2% and progressive disease 39,5 %, median TTP 3,6 months, and median OS 9,9 months).[1]
Secondly, there could be more patients who would participate in the study. However, this doesn’t affect the statistical importance of the results. On the other hand, Sella, et al.[2] and Jeske, et al.[3] similarly reported statistically significant, in agreement, prior studies demonstrating obvious clinical benefit of the taxane-effectiveness towards prostate cancer.
The data presented in the current study indicate that the biweekly administration of a paclitaxel/carboplatine regimen in patients with castration-resistant prostate cancer, pretreated with docetaxel, is an active and well-tolerated regimen in terms of salvage treatment. It would be of interest to see it compared with cabazitaxel in a prospective randomized phase III study.
References:
- Paclitaxel in combination with carboplatin as salvage treatment in patients with castration-resistant prostate cancer: a Hellenic oncology research group multicenter phase II study. Kentepozidis N, Soultati A, Giassas S, Vardakis N, Kalykaki A, Kotsakis A, Papadimitraki E, Pantazopoulos N, Bozionellou V, Georgoulias V. Cancer Chemother Pharmacol. 2012 Jul;70(1):161-8. Epub 2012 Jun 3.
- Paclitaxel, estramustine and carboplatin combination chemotherapy after initial docetaxel-based chemotherapy in castration-resistant prostate cancer. Sella A, Yarom N, Zisman A, Kovel S. Oncology. 2009;76(6):442-6. Epub 2009 May 5.
- Carboplatin plus paclitaxel therapy after docetaxel in men with metastatic castrate resistantprostate cancer. Jeske S, Tagawa ST, Olowokure O, Selzer J, Giannakakou P, Nanus DM. Urol Oncol. 2011 Nov-Dec;29(6):676-81. Epub 2010 May 7.
Written by:
N. Kentepozidis as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Medical Oncology
251 Air Force Hospital
2, P. Kanellopoulou Str.
115 25 Athens, Greece
