Initial biopsy Gleason score as a predictive marker for survival benefit in patients with castration-resistant prostate cancer treated with docetaxel: data from the TAX327 study.
Eur Urol
; 66(2): 330-6, 2014 Aug.
Article
em En
| MEDLINE
| ID: mdl-23957945
ABSTRACT
BACKGROUND:
Since 2004, docetaxel has been the standard first-line systemic therapy for patients with metastatic castration-resistant prostate cancer (mCRPC). With abiraterone recently becoming available in the predocetaxel setting, it is warranted to identify subgroups of patients who may obtain the greatest benefit from docetaxel and particularly qualify for receiving docetaxel as first-line treatment for mCRPC.OBJECTIVE:
We aimed to identify factors that could characterize subgroups of patients who obtain the greatest benefit from the use of docetaxel. DESIGN, SETTING, ANDPARTICIPANTS:
TAX327 was multinational, randomized, phase 3 study that was conducted from 2000 to 2002 in 1006 men with mCRPC. INTERVENTION Patients were randomized to receive docetaxel every 3 wk (D3), weekly docetaxel (D1), or mitoxantrone every 3 wk (M3), each with prednisone. OUTCOME MEASUREMENTS AND STATISTICALANALYSIS:
We investigated whether patients with poorly differentiated tumors (Gleason score ≥7) at diagnosis had greater benefit from D3 compared with M3 than patients with better differentiated tumors (Gleason score ≤6). Using a Cox model, we compared overall survival (OS) between the treatment groups within each subgroup of Gleason score. RESULTS ANDLIMITATIONS:
The TAX 327 data showed that the OS benefit of D3 versus M3 was greater in patients with high-grade tumors (median OS 18.9 vs 14.5 mo; p=0.009) than in patients with low-grade tumors (median OS 21.6 vs 20.7 mo; p=0.674). Limitations of a retrospective analysis apply.CONCLUSIONS:
The survival benefit obtained with docetaxel is most pronounced in patients with high-Gleason-score tumors (Gleason ≥7). In a time of shifting paradigms in mCRPC, with abiraterone becoming available prior to docetaxel chemotherapy, Gleason score may help in selecting patients who obtain the greatest benefit from docetaxel as first-line treatment for mCRPC. Prospective validation of these findings is warranted.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ósseas
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Adenocarcinoma
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Taxoides
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Neoplasias de Próstata Resistentes à Castração
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Estadiamento de Neoplasias
/
Antineoplásicos
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
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Male
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article