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Feasibility study of a randomized controlled trial comparing docetaxel chemotherapy and androgen deprivation therapy with sequential prostatic biopsies from patients with advanced non-castration-resistant prostate cancer

Lookup NU author(s): Dr James Wilson, Dr Ashraf Azzabi, Dr Jacqueline Stockley, Professor Naeem Soomro, Garrett Durkan

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Abstract

© 2015 Elsevier Inc. Background and objective: Sequential tissue biopsies taken during clinical trials of novel systemic anticancer therapies for advanced prostate cancer (PCa) may aid pharmacodynamic evaluation and biomarker discovery. We conducted a single institution phase-II open-labeled randomized study to assess the safety, tolerability, and early efficacy of docetaxel chemotherapy plus androgen deprivation therapy (ADT) vs. ADT alone for patients with advanced non-castration-resistant PCa with sequential prostatic biopsies. Patients and methods: We randomized 30 patients with newly diagnosed high-grade locally advanced or metastatic (cT3-4/N0-1/M0-1) PCa to receive ADT with (n = 15) or without (n = 15) docetaxel. Transrectal ultrasound-guided prostatic biopsies were taken at randomization and ~22 weeks after treatment initiation. Primary end point: biochemical response rate. Secondary end points: time to progression and tumor profiling. Results: Both treatments appear to be well tolerated, and there was no difference in mean nadir prostate-specific antigen and time to prostate-specific antigen relapse between treatment arms (P>0.05). No adverse effects of pre- and post-treatment prostatic biopsies were observed. The study was neither designed nor sufficiently powered to demonstrate statistically significant differences in oncological outcomes or safety profiles between the 2 treatment arms. Conclusions: Despite the lack of statistical power, our study suggests that docetaxel and ADT in combination may be well tolerated with apparently similar short-term efficacy compared with ADT alone for high-grade locally advanced or metastatic non-castration-resistant PCa, Sequential prostatic biopsies may provide tissue for tumor profiling to yield mechanistic or prognostic insights relating to novel systemic anticancer therapies.

Publication metadata

Author(s): Rajan P, Frew JA, Wilson JM, Azzabi AST, McMenemin RM, Stockley J, Soomro NA, Durkan G, Pedley ID, Leung HY

Publication type: Article

Publication status: Published

Journal: Urologic Oncology: Seminars and Original Investigations

Year: 2015

Volume: 33

Issue: 8

Pages: 337.e1-337.e6

Online publication date: 16/06/2015

Acceptance date: 11/05/2015

ISSN (print): 1078-1439

ISSN (electronic): 1873-2496

Publisher: Elsevier Inc.

URL: http://doi.org/10.1016/j.urolonc.2015.05.012

DOI: 10.1016/j.urolonc.2015.05.012

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