Docetaxel Based Treatment for Metastatic Castration-Resistant Prostate Cancer-our Early Experience

Abstract

Aim: Patients with metastatic prostate cancer invariably progress after primary androgen ablation and develop castration-resistant disease after a median time of 18-24 months. We report our early experience with docetaxel based chemotherapy in patients with mCRPC. Methods: Patients with rising serum Prostate-specific antigen, increasing extent of disease on bone scans and physical findings. All eligible patients with no previous treatment with any cytotoxic drug and having a good ≥80 Karnofsky performance status were included into the study. Results: 85 patients with metastatic prostate cancer presented with progressive disease following ADT. 67 (78.82%) patients with a mean age of 67.05 ± 2.11 accepted further treatment with docetaxel based chemotherapy, whereas the remaining 18 (21.18%) patients with mean age of 68.0 ± 4.47 years did not undergo further treatment. The overall survival was 32.61 ± 6.09 months in patients receiving docetaxel based chemotherapy as compared to 12.83 ± 2.40 months in patients in the no treatment group. The Serum PSA values at 3 and 9 months after initiation of treatment showed a downward trend in all the three risk groups receiving docetaxel. Conclusions: In our study the overall survival was 32.61 ± 6.09 months in patients receiving docetaxel. Serum PSA decline rates at least 50% from baseline was seen in 34.32% of patients at 3 months on docetaxel treatment. Docetaxel was also effective in pain reduction, decline in serum PSA levels and improvement in health related quality of life. Our study demonstrates significant response rates to docetaxel chemotherapy but that a considerable number of patients had treatment-related complications. This highlights the need for careful patient selection and optimization of chemotherapy dosing.