A multicenter, randomized clinical trial comparing the three-weekly docetaxel regimen plus prednisone versus mitoxantone plus prednisone for Chinese patients with metastatic castration refractory prostate cancer

PLoS One. 2015 Jan 27;10(1):e0117002. doi: 10.1371/journal.pone.0117002. eCollection 2015.

Abstract

Purpose: To explore the feasibility and efficacy of docetaxel plus prednisone for Chinese population with metastatic castration refractory prostate cancer (mCRPC).

Patients and methods: A total of 228 patients recruited from 15 centers were randomized to receive 10 cycles of D3P arm (docetaxel: 75 mg/m2, intravenous infusion, every three weeks; Prednisone 10mg orally given daily) or M3P arm (mitoxantrone: 12 mg/m2, intravenous infusion, every three weeks; Prednisone 10mg orally given daily). Primary end point was overall survival, and secondary end points were events progression-free survival (PFS), response rate, response duration. Quality of life (QoL) was also assessed in both treatment groups.

Results: The median overall survival was 21.88 months in D3P arm and 13.67 months in M3P arm (P = 0.0011, hazard ratio = 0.63, 95% confidence interval, 0.46-0.86). Subgroup analysis was consistent with the results of overall analysis. Events progression-free survival (pain, PSA, tumor and disease) were significantly improved in D3P arm compared with M3P arm. PSA response rate was 35.11% for patients treated by D3P arm and 19.39% for M3P arm (P = 0.0155). Pain response rate was higher in D3P arm (61.11%, P = 0.0011) than in M3P (23.08%) arm. No statistical differences were found between D3P arm and M3P arm for QoL, tumor response rate and response duration of PSA and pain. The tolerability and overall safety of D3P arm were generally comparable to that of M3P arm.

Conclusions: Compared with M3P arm, D3P arm significantly prolonged overall survival for the Chinese patients with mCRPC and improved the response rate for PSA and pain.

Trial registration: clinicaltrials.gov NCT00436839.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • China
  • Disease-Free Survival
  • Docetaxel
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • Prednisone / administration & dosage
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Quality of Life
  • Taxoids / administration & dosage
  • Treatment Outcome

Substances

  • Taxoids
  • Docetaxel
  • Mitoxantrone
  • Prednisone

Associated data

  • ClinicalTrials.gov/NCT00436839

Grants and funding

This study was sponsored by Sanofi-Aventis company. The study protocol was designed by Sanofi-Aventis personnel, and reviewed and approved by all the study co-authors. All the centers involved in this study received grants from Sanofi-Aventis for recruiting patients and conducting this clinical trial. The data were collected and maintained by Sanofi-Aventis. The statistical analysis was undertaken by an independent statistical department receiving fees from Sanofi-Aventis, but these results were not seen by Aventis, or the study co-authors, or any other investigators until the study closed. Tie Zhou and Shu-xiong Zeng drafted the manuscript and it was reviewed and approved by the all the co-authors. Sanofi-Aventis also reviewed the manuscript, but its final content was entirely determined by the co-authors. We also appreciate the supports from Changhai hospital GCP platform (2012ZX09303011-002).