Randomized trials have clearly demonstrated that when low dose Prednisone (P) is combined with docetaxel chemotherapy (D) to treat prostate cancer there is a survival benefit. What is the role of the prednisone and does it actually provide any additional benefit to the docetaxel treatment itself?

To answer this question a retrospective study was performed that investigated whether the co-administration of low-dose glucocorticoids (P) has any additional clinical benefits over D alone.

The researchers took the records of 358 men with metastatic castration-resistant prostate cancer treated consecutively with either docetaxel (D) 75mg/m(2) every 3 weeks (n = 124) or D combined with prednisone  (P) 10mg daily (n = 234).

They found that the men treated with D alone had a higher incidence of:

  • Peripheral Edema (32% vs. 15%, P<0.001)
  • Grade 3 non-hematological toxicity (56% vs. 43%, P = 0.022).
  • Men treated with D alone were more frequently hospitalized (53% vs. 41%, P = 0.035), mainly owing to a higher incidence of febrile neutropenia in this group (25% vs. 10%, P<0.001).

However, they did find that P did NOT influence the men’s progression-free survival or their overall survival when adjusting for baseline levels of hemoglobin, alkaline phosphatase, lactate dehydrogenase, prostate-specific antigen, and Eastern Cooperative Oncology Group performance status (hazard ratio P = 0.98, 95% CI: 0.76-1.26, P = 0.89, Cox proportional hazard regression model).

They concluded that the co-administration of low-dose prednisone reduced the incidence of peripheral edema, non-hematological toxicity, and the risk of being admitted owing to febrile neutropenia during treatment with docetaxel.

Adjusted survival analysis did not indicate that P affected prognosis.

PMID: 26254696