The benefit of taxanes in hormone-resistant prostate cancer

The authors aimed to determine the effects of taxanes when treating prostate cancer patients with hormone-resistant cancer. 

Hormone therapy is a common prostate cancer treatment. It targets the male sex hormones active in prostate cancer, such as testosterone. Some patients may become hormone-resistant. This means that patients will no longer respond to hormone treatment.

Taxanes are a class of chemotherapy drugs that prevent cancer cell division and new cancer cells forming. Examples of taxanes include paclitaxel (Taxol), docetaxel (Taxotere) and cabazitaxel (Jevtana). 

This study reviewed other studies that evaluated taxanes as a treatment option for hormone-resistant prostate cancer.

In one trial, 1,006 patients were given docetaxel once a week or every three weeks or were given another chemotherapy agent. Patients who received docetaxel had significantly improved overall survival (patients who did not die following treatment). Patients who received docetaxel every three weeks had an overall survival of 19.2 months. In comparison, overall survival was 17.8 months in patients who received docetaxel weekly. Docetaxel reduced patient pain and improved prostate specific antigen (PSA – protein elevated in the blood in the presence of prostate cancer) response. It also improved patient quality of life (ability to function on a physical, emotional and social level).

Patients in a second trial were given standard chemotherapy treatment with or without docetaxel every 3 weeks. Docetaxel resulted in a significantly improved overall survival of 17.5 months. In comparison, overall survival was 15.6 months in patients who received standard treatment only. Docetaxel treatment improved PSA response by 50%, compared to 27% in the standard treatment group. Patients treated with docetaxel had an average of 6.3 months without experiencing cancer progression. Patients on standard treatment had an average of 3.2 months.

In a third trial, patients treated with cabazitaxel had a significantly improved overall survival of 15.1 months. Overall survival was 12.7 months in patients who received standard treatment. Patients had over double the odds of surviving prostate cancer for more than 2 years when given cabazitaxel (27%) compared to standard treatment (16%).

Low immune cell count (cells that fight off disease), blood clotting cells and oxygen-carrying cells were the most frequent side-effects to treatment. Fevers in patients with low immune cell counts, diarrhea and moderate to severe skin reactions were also common side effects.

The authors concluded that both docetaxel and cabazitaxel can improve overall survival in patients with hormone-resistant prostate cancer. 

Further studies are required to determine long-term benefits and side effects to treatment. 

If you are considering taxane treatment, please consult your doctor for potential risks and benefits.