A group of researchers from the Dipartimento di Endocrinologia ed Oncologia Clinica e Molecolare, Università Federico II, Napoli, Italy wanted to know if retreatment with docetaxel could be tolerated and have a positive effect in men with castration-resistant prostate cancer (CRPC) who have already failed chemotherapy.

The researchers evaluated 45 men who had initially responded to docetaxel therapy and then had disease progression. The prospective multicenter study was conducted between November 2005 and January 2009. The men in the study were retreated with docetaxel (chemotherapy).

The researchers used a primary endpoint of a biochemical response (biochemical partial response defined as >50% prostate-specific antigen

[PSA] decline). The secondary endpoints were objective response, toxicity, progression-free survival (PFS) and overall survival (OS).

• Partial PSA responses were observed in 11 men (24.5%)

• Four (4) men had an objective response

• The treatment was well tolerated, with grade 1-2 neutropenia, thrombocytopenia, vomiting and peripheral
neuropathy noted in 18 (40%), 11 (24.5%), 8 (17.8%), and 6 (13.3%) men, respectively

• The most common grade 3 toxicity was neutropenia, which was observed in 8 men (17.8%)

• Median PFS was 5 months

• Median OS was 13 months.

They concluded that docetaxel re-treatment preserves anti-tumor activity and is well tolerated in a selected population of pretreated patients with CRPC. They also added that further randomized trials are needed to confirm these results.

Reference: BJU Int. 2010 Jun 29. Epub ahead of print.
doi: 10.1111/j.1464-410X.2010.09498.x ; Di Lorenzo G, Buonerba C, Faiella A, Rescigno P, Rizzo M, Autorino R, Perdonà S, Riccardi N, Scagliorini S, Scognamiglio F, Masala D, Ferro M, Palmieri G, Aieta M, Marinelli A, Altieri V, De Placido S, Cartenì G.

PubMed Abstract
PMID: 20590545

Joel T Nowak, MA, MSW