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Related Experiment Video

Updated: Jan 8, 2026

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Docetaxel with Androgen Deprivation and Radiotherapy in High-risk Localized Prostate Cancer: An ICECaP Individual

Praful Ravi1, Lucia Kwak1, Wanling Xie1

  • 1Dana-Farber Cancer Institute, Boston, MA, USA.

European Urology Oncology
|December 18, 2025
PubMed
Summary

Adding docetaxel to radiotherapy and androgen deprivation therapy did not improve metastasis-free survival or overall survival for high-risk localized prostate cancer. Further research is needed to identify patients who may benefit from this intensified treatment.

Keywords:
Androgen-deprivation therapyDocetaxelHigh-risk prostate cancerIndividual patient data meta-analysisMetastasis-free survivalRadiotherapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Oncology

Background:

  • High-risk localized prostate cancer (HRLPC) treatment often involves radiotherapy (RT) and androgen deprivation therapy (ADT).
  • The addition of docetaxel to RT + ADT is not a standard of care for HRLPC.
  • Individual patient data (IPD) meta-analysis is crucial for evaluating treatment efficacy in HRLPC.

Purpose of the Study:

  • To assess the efficacy of adding docetaxel to RT + ADT for HRLPC.
  • To evaluate the impact on metastasis-free survival (MFS), overall survival (OS), event-free survival (EFS), prostate cancer-specific mortality (PCSM), and time to metastasis (TTM).

Main Methods:

  • IPD from 1690 patients with HRLPC across four trials were collated from the ICECaP repository.
  • Patients were treated with RT + ADT ± docetaxel.
  • One-stage IPD meta-analysis using multivariable Cox proportional hazards and Fine-Gray competing risk models was performed.

Main Results:

  • Docetaxel addition did not significantly improve MFS (HR 0.89) or OS (HR 0.88).
  • A significant benefit was observed in EFS (HR 0.87) and PCSM (HR 0.70).
  • No clear evidence of greater benefit in very-high-risk versus high-risk disease was found, with no statistically significant interaction.

Conclusions:

  • The addition of docetaxel to RT + ADT does not significantly improve MFS or OS in HRLPC.
  • Biomarkers and clinical stratification are needed to identify HRLPC patients who may benefit from docetaxel intensification.
  • Future research should focus on personalized treatment strategies for HRLPC.