- Significant quality-adjusted survival benefits were seen with early docetaxel in patients with metastatic castrate-naive prostate cancer (MCNPC), particularly those with high-volume disease.
Why this matters
- Treatment-related toxicity can negatively affect survival benefits in patients with cancer.
- Quality-Adjusted Time Without Symptoms of Disease and Toxicity of Treatment (Q-TWiST) evaluates trade-offs between toxicity, progression-free interval, and survival.
- This is the first study to perform Q-TWiST analysis in metastatic prostate cancer.
- This post hoc study analyzed Q-TWiST for androgen deprivation therapy (ADT) plus docetaxel (ADT+D, n=192) and ADT (n=193) groups in the Genito-Urinary Oncology Group-AFU 15 trial.
- OS was divided into 3 phases: end of treatment-related toxicity (TOX), progression free (TWIST), and death/end of follow-up from progression (PROG).
- The durations were then weighted by utility (U; range, 0-1) to determine Q-TWiST.
- Funding: Institut de Recherche en Santé Publique.
- Q-TWiST significantly favored ADT+D at Uprog <0.4.
- In patients with high-volume disease, Q-TWiST benefit was seen with ADT+D at Uprog <0.35, regardless of Utox.
- In patients with low-volume disease, no benefit in ADT arm was observed with any Uprog and Utox combination.
- Same value attributed to all toxicities in all patients.