Weekly versus 2-weekly versus 3-weekly docetaxel to treat metastatic castration-resistant prostate cancer

To compare the efficacy and toxicity of docetaxel treatment regimens in metastatic castration-resistant prostate cancer (mCRPC).

We retrospectively analyzed 162 patients diagnosed with mCRPC who underwent docetaxel chemotherapy between 2009 and 2020. The patients were divided into three groups according to the dosage and interval of docetaxel (DCT) chemotherapy regimen: 30 mL/m² weekly, 50 mL/m² biweekly (every 2 weeks), and 75 mL/m² triweekly (every 3 weeks).

There were no significant differences in the prostate-specific antigen (PSA) response rates (P = 0.709). The median time to progression was 3.0 [interquartile range (IQR 2.0-5.3)] months, 5.0 (IQR 2.0-13.0) months, and 5.0 (IQR 3.0-12.0) months in the weekly, biweekly, and triweekly groups, respectively (P = 0.062). The median overall survival (OS) was 12.5 (IQR 6.0-14.0) months, 18.8 (IQR 5.5-23.5) months, and 22.9 (IQR 11.0-33.0) months in the weekly, biweekly, and triweekly groups, respectively (P < 0.001). There were no differences in all toxicity and Grade 3 or higher toxicity. In Cox multivariate regression analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS), response to chemotherapy, and chemotherapy cycle also affected the PFS. Age, ECOG-PS, and chemotherapy cycle affected the OS.

The various options for optimal chemotherapy are indicated depending on the patient's conditions during the diagnosis of mCRPC. Treatment with DCT at 2-week or even 1-week intervals appears to be well tolerated in men diagnosed with mCRPC and represents a useful option when the conventional triweekly regimen is not tolerated due to poor patient condition.