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Medical Oncology

, 33:77 | Cite as

Docetaxel-related toxicity in metastatic hormone-sensitive and metastatic castration-resistant prostate cancer

  • Michael T. SchweizerEmail author
  • Roman Gulati
  • Elahe A. Mostaghel
  • Peter S. Nelson
  • R. Bruce Montgomery
  • Evan Y. Yu
  • Heather H. Cheng
Original Paper

Abstract

Docetaxel plus androgen deprivation therapy (ADT) offers a survival benefit in metastatic hormone-sensitive prostate cancer (mHSPC). However, one trial evaluating docetaxel in mHSPC (GETUG-AFU15) showed unexpected toxicity; raising concerns that docetaxel may carry increased toxicity when used to treat mHSPC compared to metastatic castration-resistant prostate cancer (mCRPC). We conducted a retrospective analysis evaluating differences in toxicity based on the clinical state (i.e., mHSPC vs. mCRPC) that docetaxel was used. Patients initiating docetaxel between 1/1/2014 and 7/15/2015 were included, with the former date chosen to coincide with the press release for the first mHSPC study that showed a survival benefit with early docetaxel; ensuring contemporary docetaxel-treated cohorts. Thirty-nine mCRPC and 22 mHSPC patients were included. Compared to mCRPC, mHSPC patients were younger (median years: 66.3 vs. 71.8, P = 0.007); had better performance status (ECOG 0-1: 100 vs. 62 %, P < 0.0001); and used opiates less frequently (29 vs. 66 %, P = 0.04). Neutropenic fevers occurred in 9 and 5 % (P = 0.95) of men with mHSPC and mCRPC, respectively. Other toxicities also occurred at similar rates between cohorts. The incidence of any toxic event was 73 and 67 % (P = 0.84) for men with mHSPC and mCRPC, respectively. Within the mHSPC cohort, neutropenic fevers occurred at a similar rate regardless of the time interval between initiating ADT and the start of docetaxel. We did not observe a significant difference in toxicity between mHSPC and mCRPC patients receiving docetaxel. However, the small sample size and retrospective nature of this study limit our ability to draw definitive conclusions.

Keywords

Prostate cancer Docetaxel Toxicity Castration-resistant Hormone-sensitive Adverse event Neutropenia Neutropenic fever 

Notes

Acknowledgments

This work was supported by NCI award number P50CA097186, the University of Washington/Fred Hutchinson Cancer Research Center Institute for Prostate Cancer Research, and the Prostate Cancer Foundation. The authors would like to acknowledge Agnes Gawne for her help with the genitourinary cancer CAISIS database.

Compliance with ethical standards

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Michael T. Schweizer
    • 1
    • 2
    Email author
  • Roman Gulati
    • 3
  • Elahe A. Mostaghel
    • 1
    • 2
  • Peter S. Nelson
    • 1
    • 4
  • R. Bruce Montgomery
    • 1
    • 2
  • Evan Y. Yu
    • 1
    • 2
  • Heather H. Cheng
    • 1
    • 2
  1. 1.Division of Oncology, Department of MedicineUniversity of WashingtonSeattleUSA
  2. 2.Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  4. 4.Division of Human BiologyFred Hutchinson Cancer Research CenterSeattleUSA

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