Maia MC, et al. - Researchers performed an efficacy and safety evaluation of docetaxel as first-line chemotherapy for patients with metastatic castration-resistant prostate cancer (mCRPC). Elderly patients who had good performance status tolerated docetaxel well. Compared to younger patients, elderly patients demonstrated similar decline in rates of prostate-specific antigen (PSA) and time to progression (TTP) but had lower median survival.

Methods

• Patients with mCRPC and a Karnosfky performance status of 60% or greater treated with docetaxel on any schedule as first-line chemotherapy from 2008 to 2013 were retrospectively identified.
• In this population, a comparison of median overall survival (OS) according to age was assessed as the primary end point.
• Comparisons of the rates of severe toxicities, prostate-specific antigen (PSA) decline of 50% or greater, and TTP were the secondary end points.
• Stratification of results by three age groups (younger than 65 years, 65 to 74 years, and 75 years or older) was done.

Results

• Researchers included 197 patients; of these, 68 (34%) were younger than 65 years, 85 (43%) were 65 to 74 years, and 44 (22%) were 75 years or older.
• The groups showed no differences regarding the mean number of comorbidities (1.19 vs 1.32 vs 1.43; P=.54).
• A higher cumulative dose of docetaxel was given to patients younger than 65 years (450 mg/m² vs 382 mg/m² vs 300 mg/m²; P=.004).
• Among all groups, the rates of PSA decline of 50% or greater (41% vs 47% vs 36.4%; P=.51) and the median TTP (5.13 vs 5.13 vs 4.7 months; P=.15) were comparable.
• The group of patients younger than age 65 years showed longer median OS (19.6 vs 12.4 vs 12.3 months; P=.012).
• Groups displayed no differences in rates of any grade 3 or higher adverse event (63.2% vs 71.8% vs 54.5%; P=.14).