Experts project the diagnosis of over 300,000 prostate cancer cases in the United States in 2006, along with over 30,000 prostate cancer-related deaths. As such, prostate cancer remains the most commonly diagnosed cancer in men, and the second most deadly. The high incidence and lethality of this disease demonstrate the need for novel therapies.
An advanced subtype of prostate cancer, metastatic castration-resistant prostate cancer (mCRPC), remains particularly refractory to available treatments. In these cases, cancer has spread to distant parts of the body and does not respond to traditional hormone therapies, which reduce testosterone levels in the body. A highly aggressive disease, mCRPC accounts for the majority of prostate cancer-related deaths.
Due to the lack of efficacy with hormone therapies, mCRPC patients receive docetaxel, a chemotherapy from the taxane family of drugs. Taxanes prevent cells from dividing and target rapidly dividing cells, including cancer cells.
In 2010, the FDA approved another taxane chemotherapy, cabazitaxel, for mCRPC patients who had previously received docetaxel. However, no studies have compared the efficacy of docetaxel rechallenge with that of cabazitaxel.
To address this question, a team of researchers conducted a retrospective study, which they recently published in the journal JAMA Network Open. The comparison included patients who received initial docetaxel treatment and did not experience disease progression. The researchers identified 669 men who met study criteria. The average age of the men in the study was 72. After initial docetaxel, 407 patients received cabazitaxel, while 262 received docetaxel rechallenge.
The analysis revealed that patients receiving docetaxel rechallenge had, on average, about one year longer overall survival than those receiving cabazitaxel. The results of the study suggest that mCRPC patients who do not experience progression after docetaxel would benefit from docetaxel rechallenge before cabazitaxel. Notably, rechallenge with docetaxel presents a more cost-efficient option for treatment, with substantially lower drug costs than that of cabazitaxel.
Sources: CA Cancer J Clin, J Natl Compr Canc Netw, JAMA Netw Open, Asian J Urol
