Adding carboplatin to chemotherapy regimens for refractory metastatic castration-resistant prostate cancer (mCRPC) may improve survival, researchers reported at the American Urological Association 2020 Virtual Experience.
Mohamed E. Ahmed, MD, and colleagues at Mayo Clinic retrospectively identified 150 patients with mCRPC who experienced disease progression on second-generation hormone therapy (enzalutamide or abiraterone). Of these, 92 were chemotherapy naïve and 58 previously had received docetaxel chemotherapy before starting on enzalutamide or abiraterone. After failing second-generation hormone therapy, 90 patients were assigned to receive docetaxel alone (group A), 33 patients received carboplatin plus docetaxel (group B), and 27 received cabazitaxel alone (group C). The investigators defined a favorable response as a 50% or greater decrease in PSA from baseline after a complete course of chemotherapy.
Patients in group B were 2.6 times as likely as those in group A to have a favorable response, and a nearly 3 times as likely to have a favorable response compared with patients in group C, the investigators reported.
The 30-month overall survival rates were 70.7% for group B compared with 38.9% and 30.3% for groups A and C, respectively. Patients in group A had a significant 3.1-fold increased risk of death compared with those in group B, and patients in group C had a nearly 4.2-fold increased risk of death compared with those in group B.
The results suggest physicians consider carboplatin plus docetaxel in the late mCRPC setting after patients progress on second-generation hormone therapy, Dr Ahmed’s group concluded.
Addition of carboplatin to chemotherapy regiments for metastatic castrate resistant prostate cancer in post-2nd generation hormone therapy setting: does it improve survival? Presented at the American Urological Association 2020 Virtual Experience held in May. Abstract MP79-17.