Can androgen deprivation therapy combined with docetaxel plus prednisone improved outcomes in patients with metastatic hormone-sensitive prostate cancer?

The aim of this study was to evaluate the safety and effectiveness of combining androgen deprivation therapy (ADT) with docetaxel (Taxotere) plus prednisone (Deltasone) in the treatment of metastatic hormone-sensitive prostate cancer (mHSPC). The study found that this combination improved the outcomes of these patients.

Prostate cancer (PCa) remains to be an increasingly common form of cancer in men. ADT is a type of hormonal treatment and is the standard care for advanced Pca. ADT can cause cancerous cells to shrink, or grow more slowly. HSPC is a form of PCa where the tumor responds to ADT. PSA is a protein produced by the prostate. Its levels are elevated in patients with PCa. PSA is often used to monitor the progression of PCa. 

Docetaxel is a form of chemotherapy used to treat a variety of different cancers. Prednisone is a steroid hormone. It has been shown that in patients with mHSPC (PCa that has spread to distant organs and tissues) ADT and chemotherapy improve survival. However, the outcomes of patients with mHSPC treated with ADT and docetaxel plus prednisone (DP) are still under investigation.

There were 151 patients with mHSPC involved in this study. 85 patients received ADT with 6 cycles of docetaxel and prednisone (DP group). 66 patients received ADT alone (control group). They were followed up for an average of 34 months.

Overall survival was 59% higher in the DP group compared to the control group. Time without PSA levels rising was significantly longer with the DP group compared to the control group (17.9 months vs 9.2 months). Treatment success was considered when PSA levels fell to 0.2 ng/mL. 53.7% of the DP group achieved this PSA level compared to 23.3% of the control group.

Radiographic progression-free survival (rPFS) is when there is no worsening of PC seen on imaging tests. RPFS was 72% higher in the DP group (43 months) compared to the control group (19.8 months).

Serious side effects occurred less in the DP group (10.9%) compared to the control group (22.5%). The side effects reported were increased blood toxicity, fever, gastrointestinal upset, fluid retention, and fatigue. 

The authors concluded that the use of early ADT with DP in patients with mHSPC improved the outcomes of these patients.

This study used medical records data. Information might have been incomplete. Also, the study population was small. Further studies are needed to confirm these results.