Body fat and docetaxel treatment in advanced prostate cancer

The authors determined how body weight could influence patient outcome following docetaxel (Taxotere) treatment in patients with metastatic cancer (that has spread) prostate cancer. 

Advanced prostate cancer is cancer that has spread outside the prostate gland to different organs. Many advanced prostate cancer cases are also hormone-resistant (castration-resistant). Hormone therapy is a common treatment used in prostate cancer. It targets the male sex hormones active in prostate cancer, such as testosterone. Hormone-resistant cancer is cancer that will no longer respond to hormone therapy and will require further treatment. Docetaxel is a treatment that has been approved for the treatment of advanced hormone-resistant prostate cancer. It is a chemotherapy drug capable of dissolving in or absorbing fat cells. Men who have a high body mass index (BMI – measures body fat based on weight and height) may be more at risk of advanced prostate cancer.

Further studies are needed to determine how weight can influence docetaxel treatment in patients with advanced prostate cancer. 

The aim of this study was to determine how weight influenced patient outcome in obese men with advanced prostate cancer treated with docetaxel.

333 patients were used in this study. 78% of patients were obese (BMI greater than or equal to 25) or overweight (BMI greater than or equal to 30). 22% of patients had a normal body weight (BMI18.5 to 25). All patients were treated with docetaxel.

Patients were separated into two groups. Group 1 (98 patients) received docetaxel weekly. Group 2 (235 patients) received docetaxel every three weeks.

At both diagnosis and docetaxel initiation, obese patients in groups 1 and 2 were significantly younger than patients with normal BMI in group 1 and 2. Time from diagnosis until docetaxel initiation was significantly shorter in obese patients in group 1 compared to normal BMI patients in group 1 and, obese and overweight patients in group 2. Obese and overweight patients in group 1 had a longer overall survival (patients still alive after treatment) of 26.6 months compared to 17.8 months group 2.

Patients with a high visceral fat-to-subcutaneous fat area ratio (VSR –fat content found around the organs compared to fat content in the skin cells) were associated with a poor prognosis (course of disease) and had a shorter time from start of docetaxel treatment until death. Patients with a high visceral fat-to-muscle area ratio (VMR – fat content found around the organs compared to skeletal muscle area) and a high BMI were associated with an increased duration from starting docetaxel until death and longer survival after docetaxel treatment.

The authors concluded that overweight and obese patients would benefit more from weekly docetaxel treatment compared to every three weeks.