Docetaxel as a vital option for corticosteroid-refractory prostate cancer

The efficacy of docetaxel (TAX) chemotherapy for corticosteroid-refractory refractory prostate cancer (CRPC) is uncertain.

We retrospectively reviewed outcomes of 51 men with corticosteroid-refractory CRPC treated at our institute. Of them, 24 men had received only dexamethasone (DEX) before the approval of TAX (historical control). The remaining 27 men who had already become DEX refractory on the approval of TAX underwent TAX plus DEX.

The median overall survival for men treated with TAX plus DEX (17.6 months) was significantly longer than men with DEX (8.1 months, P = 0.021). On univariate analysis, performance status, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), prostate specific antigen (PSA), and TAX therapy were significant factors for overall survival. Of these, performance status and TAX therapy remained as the significant factor on multivariate analysis. No significant benefit was detected for men with advanced disease such as poorer performance status, elevated LDH, elevated ALP, or high PSA. Grades 3, 4 toxicities including anemia (19%), leukocytopenia (26%), and neutropenia (26%) were found in TAX cases.

Our results suggest that TAX would be a vital option for DEX refractory CRPC possibly with more efficacy for less advanced stages.