HealingWell
Search Close Search
☰

Early Chemo (with ADT) - 10 to 22 months Survival Benefit (New Data)

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/14/2015 10:46 AM (GMT 0)
This might change the timing of chemo for some patients. Looks like a huge survival benefit if taken early, but a tough call to go straight to chemo.

www.medscape.com/viewarticle/844643

The results presented by Dr James and colleagues at the meeting come from an analysis of 2962 men with newly diagnosed advanced prostate cancer. about 60% had metastatic disease, the rest had high-risk locally advanced nonmetastatic disease (either node-positive, or with two of three of the following risk factors: stage T3/T4, PSA ≥ 40 ng/mL, or Gleason sum score of 8–10).

All of these men received standard of care, which was at least 3 years of ADT, with radiation for patients who were suitable. In addition, some men also received docetaxel for six cycles, zoledronic acid for 2 years, or both docetaxel and zoledronic acid.

After a median follow-up of 42 months, 948 men had died.

The addition of docetaxel significantly improved median overall survival to 77 months, compared with 67 months for ADT alone.

For the subgroup of patients with metastatic disease, the survival benefit was even greater, with median overall survival of 65 vs 43 months on ADT alone. For this group of men with newly diagnosed metastatic prostate cancer, docetaxel upfront should become routine practice, Dr James said at the press briefing, and he suggested that clinical guidelines will be changed soon to incorporate such a recommendation.

However, in the other subgroup of patients with advanced but not metastatic disease, the difference in survival was not statistically significant, but these survival data are still immature, Dr James noted. However, docetaxel prolonged the event-free survival by "a substantial amount," and so it should also be considered in this group, he said.

There was an increase in toxicity with the addition of docetaxel. Grade 3/4 toxicity was reported by 30% of patients in the standard of care group, by 50% of patients who also took docetaxel, by 32% of patients who also took zoledronic acid, and by 50% of patients who also took both docetaxel and zoledronic acid.

However, the researchers say the adverse effects were "manageable," and add that very few patients discontinued because of them.
Posted 5/14/2015 3:19 PM (GMT 0)
Thanks, Jerry.

Two proofs are better than one, making this formerly treatment of last resort, now one of the more preferred ones.
Posted 5/14/2015 6:43 PM (GMT 0)
So very thankful to see this link today as my husband and I are headed to medical oncologist tomorrow to discuss this very treatment. On ADT husbands PSA is best it has been at 0.5, he is feeling great and as physically healthy as he can be now which I think is the perfect time to attack the beast from all directions possible. Have the research in hand. Will let you know how it goes.
Dawn
Posted 5/14/2015 7:04 PM (GMT 0)
I'm wondering if this data, and other similar data from other studies, is relevant for guys on Intermittent Hormone Therapy (IHT) like myself.  Should my docs and I consider chemo once I come off my hormone therapy vacation?

Dawn---sounds good...let us know.

Posted 5/15/2015 2:05 AM (GMT 0)
Jerry L,

Both CHAARTED and STAMPEDE were about using Taxotere while the patient is hormone sensitive, in fact very soon after diagnosis. CHAARTED, which only looked at men with mets, showed a survival advantage overall, but it was particularly large for men with lots of mets. If there's a benefit for guys like you with just a couple of mets, it hasn't become apparent yet after 10 years of tracking them.

STAMPEDE looked at two groups: one with metastatic PC (any M1), and the other with "very high risk" PC - N1 or 2 of (PSA≥40, T3/4 or GS≥8). So far, with average 42 months of follow up, they only observed a significant benefit in the M1 group (as we'd expect from CHAARTED), but not, at least not yet, in the "very high risk" group. Unfortunately for you, they have not yet analyzed separately those with multiple mets and those with just a few.

So perhaps when the findings get published later this year there will be more guidance that is relevant to your particular situation.

Clearly, anyone who is hormone sensitive and has multiple mets, and can tolerate it, would benefit from chemo as early as possible.

- Allen
Posted 5/15/2015 2:18 AM (GMT 0)
Allen,

I really appreciate your feedback on my particular question and generally always being here to give us good info. Thank you so much!

Perhaps I can extend my HT vacation for the time it takes to get the findings published.

If I knew that it would help me long-term and it would not cause anything bad long term, I would do it with my next HT phase...despite the short term bad side effect.

I'm glad to see some real data for guys that fit the categories. For them, this should be a big deal.

Thanks again,
Jerry
✚ New Topic ✚ Reply

HealingWell

Connect With Us
© 1997-2024 HealingWell.com LLC All Rights Reserved. Our website is for informational purposes only. HealingWell.com LLC does not provide medical advice, diagnosis, or treatment.