SAN DIEGO—Intermittent docetaxel therapy for castration-resistant prostate cancer (CRPC) can decrease adverse events without impairing oncologic outcomes, according to a Japanese study presented at the American Urological Association annual meeting.
In a study of 50 CRPC patients by researcher at the University of Tokyo Hospital, 25 (50%) qualified for intermittent treatment. Patients received docetaxel 75 mg/2 every three weeks with oral dexamethasone 1.0 mg/day. Clinicians monitored PSA levels every three weeks and suspended chemotherapy if serum PSA levels decreased by more than 50% and reached a level below 4 ng/mL. Clinicians resumed treatment when serum PSA levels increased by more than 50% and was over 2 ng/mL.
Of the 25 patients in the intermittent-treatment group, 10 received a second treatment and two received a third treatment. The median first chemotherapy-free interval was 251 days and the second was 140 days. During the chemotherapy-free period, appetite loss, fatigue, diarrhea, alopecia, and nail changes were fully recovered in five of six patients (83.3%), four of eight patients (50%), three of five (60%), 13 of 17 (76.5%), and 10 of 14 (41.4%), respectively.
Motor neuropathy and sensory neuropathy were fully recovered in only one of four patients (25%) and one of 11 patients (9.1%).
Lower PSA at the start of docetaxel therapy (median less than 31 ng/mL) and absence of previous steroid therapy were associated with continuing intermittent therapy. Patients in the intermittent arm were 3.5 times more likely to survive than those in the continuous treatment arm.