Administering chemotherapy using docetaxel (taxotere or T) on a bi-weekly basis with prednisone improved progression free survival and overall survival when compared with the standard tri-weekly schedule for men with advanced castration resistant prostate cancer (CRPC) (Lancet Oncol. 2013;14:117-124). However, quality of life (QoL) differences have not been evaluated.
In a trial to evaluate the differences of QoL between the two dosing schedules three hundred and forty-six men were randomly allocated to receive intravenous therapy T of either 75 mg/m² d1 q3 wks (the triweekly arm) or 50 mg/m² d1 and d 14, q4 wks (the biweekly arm) (identifier NCT00255606).
In addition, prednisone (10 mg/d) was administered orally to both groups. The men’s baseline characteristics were well balanced between the groups with respect to the performance status, mean age and median serum prostate-specific antigen (PSA).
Quality of life (QoL), the frequency and severity of symptoms including pain were assessed using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) version 4.0 questionnaire.
After six months the baseline QoL of both treatment groups was compared to the other. They found that many of the different side effects did not differ between the groups. However, there were statistically significant differences in overall quality of life values (p=0.010) and discomforting pain values (p=0.028) favoring the bi-weekly treatment arm.
Biweekly T is better tolerated and offers a better quality of life than the triweekly standard T. Given that the biweekly schedule also improves progression free survival and overall survival the use of bi-weekly docetaxel as first line treatment should become the standard of care.
J Clin Oncol 32, 2014 (suppl 4; abstr 23): Pirkko-Liisa Irmeli Kellokumpu-Lehtinen, Ulrika Harmenberg, Petteri Hervonen, Timo K. Joensuu, Raymond S. McDermott, Claes Ginman, Marjaana Luukkaa, Paul Nyandoto, Akseli Hemminki, Sten Nilsson, John McCaffrey, Raija Asola, Taina Turpeenniemi Hujanen, Fredrik Laestadius, Tiina Tasmuth, Katinka Sandberg, Maccon M. Keane, Ilari Lehtinen, Tiina Luukkaala, Heikki
Joel T. Nowak, M.A., M.S.W.