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Burden of Metastatic Castrate Naive Prostate Cancer Patients, to Identify Men More Likely to Benefit from Early Docetaxel: Further Analyses of CHAARTED and GETUG-AFU15 Studies
- Source :
- European Urology, European Urology, Elsevier, 2018, 73 (6), pp.847-855. ⟨10.1016/j.eururo.2018.02.001⟩, European Urology, 2018, 73 (6), pp.847-855. ⟨10.1016/j.eururo.2018.02.001⟩
- Publication Year :
- 2018
- Publisher :
- HAL CCSD, 2018.
-
Abstract
- International audience; BACKGROUND:Docetaxel (D) at the time of starting androgen deprivation therapy (ADT) for metastatic castrate naive prostate cancer shows a clear survival benefit for patients with high-volume (HV) disease. It is unclear whether patients with low-volume (LV) disease benefit from early D.OBJECTIVE:To define the overall survival (OS) of aggregate data of patient subgroups from the CHAARTED and GETUG-AFU15 studies, defined by metastatic burden (HV and LV) and time of metastasis occurrence (at diagnosis or after prior local treatment [PRLT]).DESIGN, SETTING, AND PARTICIPANTS:Data were accessed from two independent phase III trials of ADT alone or ADT+D-GETUG-AFU15 (N=385) and CHAARTED (N=790), with median follow-ups for survivors of 83.2 and 48.2 mo, respectively. The definition of HV and LV disease was harmonized.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:The primary end point was OS.RESULTS AND LIMITATIONS:Meta-analysis results of the aggregate data showed significant heterogeneity in ADT+D versus ADT effect sizes between HV and LV subgroups (p=0.017), and failed to detect heterogeneity in ADT+D versus ADT effect sizes between upfront and PRLT subgroups (p=0.4). Adding D in patients with HV disease has a consistent effect in improving median OS (HV-ADT: 34.4 and 35.1 mo, HV-ADT+D: 51.2 and 39.8 mo in CHAARTED and GETUG-AFU15, respectively; pooled average hazard ratio or HR (95% confidence interval [CI]) 0.68 ([95% CI 0.56; 0.82], p
- Subjects :
- Oncology
Male
medicine.medical_specialty
Urology
030232 urology & nephrology
Bone Neoplasms
[SDV.CAN]Life Sciences [q-bio]/Cancer
Disease
Docetaxel
Metastatic castrate naive prostate cancer
Androgen deprivation therapy
Metastasis
Gonadotropin-Releasing Hormone
03 medical and health sciences
Prostate cancer
Metastatic prostate cancer
0302 clinical medicine
High volume
[SDV.CAN] Life Sciences [q-bio]/Cancer
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Clinical endpoint
Humans
Chemotherapy
Neoplasm Metastasis
Low volume
Aged
Randomized Controlled Trials as Topic
business.industry
Hazard ratio
Prostatic Neoplasms
Androgen Antagonists
Middle Aged
medicine.disease
Prognosis
Confidence interval
3. Good health
Tumor Burden
Survival Rate
Clinical Trials, Phase III as Topic
030220 oncology & carcinogenesis
Volume disease
business
Orchiectomy
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 03022838 and 1421993X
- Database :
- OpenAIRE
- Journal :
- European Urology, European Urology, Elsevier, 2018, 73 (6), pp.847-855. ⟨10.1016/j.eururo.2018.02.001⟩, European Urology, 2018, 73 (6), pp.847-855. ⟨10.1016/j.eururo.2018.02.001⟩
- Accession number :
- edsair.doi.dedup.....268d1e460fcbece64024709d2d4be616