We know that docetaxel chemotherapy (chemo) extends life, but which men might hope to experience an increase in survival?

The Department of Urology, All India Institute of Medical Sciences, New Delhi, India performed a small study designed to evaluate the efficacy of docetaxel/prednisone and zoledronic acid in the treatment of men with hormone refractory prostate cancer (HRPC) as well as to analyze prognostic factors predicting overall survival.

This small study with Forty-four men with HRPC were given docetaxel (75 mg/m(2)), prednisone and zoledronic acid (4 mg) every three weeks. They then calculated the overall and progression-free survival curves. Using the log-rank test, variables predicting overall survival (age, Gleason score, baseline prostate-specific antigen

[PSA], percentage PSA decline, nadir PSA, number of chemotherapy cycles) were calculated.

The median age of the menparticipating in the study  was 66 years and their mean PSA was 171.25 ng/mL.  The average number of chemo cycles was 6.3.  A good PSA response (>50% decline) was observed in 26 of the 44 men (59.1%). A total of 17 of the 44 men  (38.6%)  died with a median overall survival of 62.4 weeks.

The men who had a Gleason score less than 7, who received more than four cycles and who also had a more-than-50% decline in their  PSA scores had a significantly better survival experience. They found that variables like age, baseline PSA and nadir PSA did not significantly affect survival.

The researchers concluded that the combination of docetaxel/zoledronic/prednisone is safe and effective in the management of HRPC.  More importantly men with a Gleason score < 7, PSA decline >50% and those who received more than four cycles experienced a significantly better survival time.

Int J Urol. 2009 Sep;16(9):726-31.
Nayyar R, Sharma N, Gupta NP

PubMed Abstract

Joel T Nowak, MA, MSW