CHICAGO — Once bone pain appears in patients with hormone-refractory prostate cancer, it is often too late for docetaxel therapy to have an impact on their survival, according to a poster presentation at the annual meeting of the American Society of Clinical Oncology.
For this reason, docetaxel (Taxotere) should be started earlier, when it can do some good, said Dr. Stéphane Oudard, professor of medicine at Georges Pompidou European Hospital, Paris.
He and his colleagues conducted a retrospective analysis of 145 consecutive chemotherapy-naive, hormone-refractory prostate cancer patients. The median 3-year survival rate for 25 patients with moderate or severe pain within the 90 days of starting chemotherapy was 4% vs. 11% for 41 patients who had mild pain, and 29% for the 79 patients who had no or minimal pain. One-year survival was 52%, 56%, and 75%, respectively.
Patients with minimal or no pain survived a median of 21.4 months; those with mild bone pain 15 months, and those with moderate or severe pain 13.1 months.
Bone pain in hormone-resistant prostate cancer patients is usually associated with poor Eastern Cooperative Oncology Group (ECOG) performance status, short prostate-specific antigen (PSA) doubling time, more aggressive disease, and worse prognosis. The study was designed to explore the impact of the presence and intensity of bone pain on overall survival, and also to test the link between PSA doubling time and survival of patients with minimal or no pain.
To do so, the researchers retrospectively analyzed their institution's database of 145 consecutive chemotherapy-naive patients who had failed androgen blockade and anti-androgen withdrawal. Patients had an ECOG performance status of 2 or less and were treated with docetaxel 70–75 mg/m