Video: Dr. Kantoff on Docetaxel Plus Androgen Deprivation Therapy in Prostate Cancer

Excerpt:

“Philip W. Kantoff, MD, chair of the Department of Medicine, Memorial Sloan Kettering Cancer Center and a 2014 Giants of Cancer Care winner for Genitourinary Cancer, discusses the combination of docetaxel (Taxotere) chemotherapy and androgen deprivation therapy (ADT) in the setting of metastatic hormone-sensitive prostate cancer.

“Considering the positive results in overall survival from the CHAARTED and STAMPEDE trials, which combined ADT with docetaxel, the next step became determining which patients would benefit from this combination.”

Watch the full video here.

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Metastatic Hormone-Sensitive Prostate Cancer Should Include Docetaxel Alongside ADT

“Treatment initiation for hormone-sensitive metastatic prostate cancer should include the addition of docetaxel to androgen deprivation therapy (ADT) as standard of care. This recommendation is based on a meta-analysis1 of three large, relatively recent, randomized trials showing that docetaxel improves survival and failure-free survival (FFS) in metastatic hormone-sensitive prostate cancer. These findings move docetaxel up to the hormone-sensitive setting from its previous role as upfront treatment in the castrate-resistant setting.

“In men with metastatic hormone-sensitive prostate cancer, docetaxel added to ADT improved 4-year survival by an absolute value of 9% and reduced FFS by an absolute value of 16%.”


Cixutumumab Adds No Benefit in ADT-Sensitive Prostate Cancer

“Adding cixutumumab to androgen deprivation therapy (ADT) did not significantly increase the undetectable prostate-specific antigen (PSA) rate in men with newly diagnosed, metastatic, hormone-sensitive prostate cancer, according to results of the Southwest Oncology Group (SWOG) S0925 study published in the Journal of Clinical Oncology.

“Evan Y. Yu, MD, of the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, and colleagues randomized 210 patients to receive either ADT (bicalutamide and luteinizing hormone–releasing hormone agonist) alone or ADT plus cixutumumab. At 28 weeks, the undetectable PSA rate (≤ 0.2 ng/mL) was 40% (42 of 105 patients) in the cixutumumab arm compared with 32.3% (34 of 105 patients) in the ADT-alone arm (relative risk = 1.24, P = .16).

“The median age of patients in the trial was 65, and the median PSA levels in the control and cixutumumab arms were 31 ng/mL and 37 ng/mL, respectively…

“ ‘Although these results fail to confirm preclinical evidence supporting the combination of castration with IGF-1R inhibition by cixutumumab, it is possible that the primary endpoint of undetectable PSA at 28 weeks does not fully capture cixutumumab efficacy,’ concluded the authors.”


ADT Plus Docetaxel for Prostate Ca: Home Run or Foul Ball?

“A ‘home run’ in advanced prostate cancer did not clear the fence in a second evaluation of androgen deprivation therapy (ADT) with docetaxel, according to a study reported here.

“An updated analysis of a French study showed that adding chemotherapy to ADT did not significantly improve overall survival for men with hormone-sensitive, metastatic prostate cancer. However, the 13-month difference in favor of the docetaxel arm was comparable to the statistically significant 14-month improvement observed in a larger U.S. trial reported last year.

“The French study also failed to show a survival benefit in patients with high-volume disease, which accounted for two-thirds of the patients in the U.S. trial.

” ‘We are awaiting the analysis of [a third randomized trial], and we hope to come up with a common analysis of the three studies altogether in order to give the good [best] treatment for the good [best] patient,’ Gwenaelle Gravis, MD, of Institut Paoli-Calmettes in Marseilles, France, said here at the Genitourinary Cancers Symposium.

“For more than 40 years, ADT has represented standard of care for metastatic hormone-sensitive advanced prostate cancer. The emergence of effective chemotherapy for castration-resistant prostate cancer led to speculation that use of cytotoxic therapy in hormone-sensitive advanced prostate cancer might improve outcomes as compared with ADT alone.”


ASCO 2014 — Takeaways for Prostate Cancer Patients


Every year, thousands of people gather for the American Society of Clinical Oncology (ASCO) Annual Meeting. This year’s meeting took place in Chicago, Illinois. Here are some of the most notable new developments in prostate cancer treatment presented at ASCO 2014: Continue reading…