The analysis demonstrated that patients receiving chemotherapy in combination with ADT had a longer clinical progression-free survival interval (HR = 0.64; 95% CI: 0.55 to 0.75; p<0.00001). There was no significant heterogeneity observed between studies (Chi2 = 0.64; df = 1 [p = 0.42]; I2 = 0%). In addition, the combination of ADT with docetaxel was associated with superior overall survival (OS) compared with ADT alone (HR = 0.73; 95% CI: 0.64 to 0.84; p<0.0001), with moderate heterogeneity (Chi2 = 3.84; df = 2 [p = 0.15]; I2 = 48%).
Patients with high-volume disease also increased overall survival with combination chemo- hormonal therapy in the combined analysis (HR = 0.67; 95% CI: 0.54 to 0.83; p = 0.0003). As expected patients receiving chemotherapy had higher rates of toxicity including neutropenia, febrile neutropenia and fatigue.
The results of this meta-analysis support the use of Docetaxel in combination with ADT in select patients with hormone sensitive prostate cancer, especially patients with high volume metastatic disease.
Written by: Bishoy Faltas, MD
Efficacy and Safety of Combined Androgen Deprivation Therapy (ADT) and Docetaxel Compared with ADT Alone for Metastatic Hormone-Naive Prostate Cancer: A Systematic Review and Meta-Analysis.Botrel TE, Clark O, Lima Pompeo AC, Horta Bretas FF, Sadi MV, Ferreira U, Borges Dos Reis R. PLoS One. 2016 Jun 16;11(6):e0157660. doi: 10.1371/journal.pone.0157660. eCollection 2016