MCNPC: early docetaxel boosts quality-adjusted survival in high-volume disease

  • Eur J Cancer

  • Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Same value attributed to all toxicities in all patients.