Docetaxel-Cabazitaxel-Enzalutamide Versus Docetaxel-Enzalutamide in Patients with Metastatic Castration-resistant Prostate Cancer
Abstract
Aim: The aim of this retrospective study was to compare the efficacy of the sequence docetaxel-cabazitaxel-enzalutamide vs. docetaxel-enzalutamide in patients with metastatic castration-resistant prostate cancer. Patients and Methods: Of the cohort of 35 patients, 11 were treated with the sequence docetaxel-cabazitaxel-enzalutamide and 24 were treated with the sequence docetaxel-enzalutamide.
The doses were as follows: docetaxel, 75 mg/ m2; cabazitaxel, 25 mg/ m2; and enzalutamide, 160 mg/ day. Over all survival (OS) was defined as the interval between the initial dose of docetaxel and death or the date of the last control for survivors (censored).
OS was assessed using the Kaplan-Meier method, and the two arms were compared using the log-rank test. The significance level for all statistical tests was set at α = 0.05.
Results: The median OS of patients treated with the sequence docetaxel-cabazitaxel-enzalutamide was 28.8 months, vs. 24.4 months in patients treated with the sequence docetaxel-enzalutamide. No statistically significance differences in OS were found between the two arms (HR 0.678, 95% CI 0.264-1.744; p = 0.418).
Grade 3-4 toxicity was observed for each drug, as follows: docetaxel: fatigue and peripheral neuropathy in six patients, nausea in three patients, and diarrhea and neutropenia in one patient; cabazitaxel: anemia in two patients and neutropenia in one patient; and enzalutamide: anemia in six patients, thrombocytopenia in two patients, and cerebral hemorrhage in one patient. Conclusion: No statistically significant differences in OS were found between the sequences docetaxel-cabazitaxel-enzalutamide and docetaxel-enzalutamide.