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PCa Commentary

Chemotherapy - Updated Survival Data from TAX 327 Study: Docetaxel Plus Prednisone Versus Mitoxanthrone Plus Prednisone for Advanced Prostate Cancer. (JCO January 10, 2008)

(March 2008)

 

The updated data collected as of March 2007 reporting median survival duration for the 1,006 men with metastatic hormone-resistant prostate cancer continued to show superiority (P=.004) for Docetaxel, 75 mg/m2 (D3P), given at three week intervals compared to Mitoxanthrone (MP), 12 mg/m2 q 3 weeks: median survival 19.2 vs 16.3 months, respectively. For Docetaxel given weekly (D1P), 30 mg/m2, the median survival was 17.8 months, which did not differ significantly from the MP arm. Prednisone 5 mg BID was given in all arms. 

Docetaxel given at three week intervals "showed better palliation, with a higher probability of pain and QOL response." The study continued to show that patients on the weekly Docetaxel arm "were more likely to experience early deterioration of QOL" and that median survival in this arm was not significantly better than MP. Hence, the authors conclude that "weekly docetaxel should not be adopted." 

"The percentage of patients who survived for more than 3 years in the D3P, D1P, and MP arms were 18.6%, 16.8%, and 13.5% respectively."

The authors concede that "Although the differences in median survival are relatively small, they are accompanied by improvement in pain control and QOL and are clinically meaningful ... [and] it seems reasonable to offer treatment to patients with symptoms and to those who are likely to develop symptoms in the near future."

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