What is the Actual Clinical Benefit of Using Low Dose Prednisone Along with Prostate Cancer Chemotherapy with Docetaxel?

/, Chemotherapy, Clinical Trials & Research, Combination Therapy, docetaxel, Drugs & Treatments, edema, Hospitalization, Research, Side Effects, Survival, Uncategorized, Understanding APC/What is the Actual Clinical Benefit of Using Low Dose Prednisone Along with Prostate Cancer Chemotherapy with Docetaxel?

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

About the Author:

Leave A Comment