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Long-Term Survival Outcomes With Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer

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Key Points

  • The addition of docetaxel to ADT prolonged survival among all patients and among those with high-volume disease.
  • No survival benefit was observed among patients with low-volume disease.  

Analysis of long-term survival outcomes in the phase III CHAARTED trial showed a survival advantage with the addition of docetaxel to androgen-deprivation therapy (ADT) in patients with hormone-sensitive metastatic prostate cancer, although no advantage was observed among patients with low-volume disease. These findings were presented by Kyriakopoulos et al in the Journal of Clinical Oncology.

Study Details

In the CHAARTED trial, 790 patients were randomized between July 2006 and December 2012 to receive docetaxel plus ADT (n = 397) or ADT alone (n = 393). A previous report from interim analysis in the trial showed that the addition of docetaxel was associated with survival benefit among all patients (hazard ratio [HR] = 0.61, P < .001), with the greatest benefit among those with high-volume disease (HR = 0.6, P < .001). The current report provides survival data with a cutoff date in April 2016, representing median follow-up of 53.7 months. High-volume disease was defined as presence of visceral metastases or four or more bone metastases with at least one outside of the vertebral column and pelvis.

Survival Outcomes

At median follow-up of 53.7 months, median overall survival was 57.6 months in the docetaxel group vs 47.2 months in the ADT alone group (HR = 0.72, P = .0018). Among 513 patients with high-volume disease, median overall survival was 51.2 months vs 34.4 months (HR = 0.63, P < .001). Among 277 with low-volume disease, median overall survival was 63.5 months vs not reached (HR = 1.04, P = .86).

The investigators concluded, “The clinical benefit from chemohormonal therapy in prolonging [overall survival] was confirmed for patients with high-volume disease; however, for patients with low-volume disease, no [overall survival] benefit was discerned.”

The study was supported by the U.S. Department of Health and Human Services Public Health Service grants and the National Cancer Institute, and coordinated by the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network (ECOG-ACRIN) Cancer Research Group, which received a grant from Sanofi.

Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, is the corresponding author for the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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