2-weekly versus 3-weekly docetaxel for metastatic castration-resistant prostate cancer: complete quality of life results from the randomised, phase-III PROSTY trial

Miikka Lehtonen; Jorma Sormunen; Tiina Luukkaala; Timo Marttila; Ray McDermott; Timo Joensuu; Ilari Lehtinen; Claes Ginman; Pirkko-Liisa Kellokumpu-Lehtinen

doi:10.1080/0284186X.2022.2098680

2-weekly versus 3-weekly docetaxel for metastatic castration-resistant prostate cancer: complete quality of life results from the randomised, phase-III PROSTY trial

Acta Oncol. 2022 Aug;61(8):963-971. doi: 10.1080/0284186X.2022.2098680. Epub 2022 Jul 18.

Authors

Miikka Lehtonen^{1

2}, Jorma Sormunen^{1

3}, Tiina Luukkaala⁴, Timo Marttila⁵, Ray McDermott⁶, Timo Joensuu³, Ilari Lehtinen⁷, Claes Ginman⁸, Pirkko-Liisa Kellokumpu-Lehtinen^{1

9}

Affiliations

¹ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
² Katriina Hospital, Vantaa, Finland.
³ Docrates Cancer Center, Helsinki, Finland.
⁴ Research, Development and Innovation Center, Tampere University Hospital and Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
⁵ Seinäjoki Central Hospital, Seinäjoki, Finland.
⁶ St Vincent's University Hospital and Cancer Trials, Dublin, Ireland.
⁷ Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland.
⁸ Karlstad Central Hospital, Karlstad, Sweden.
⁹ Tampere University Hospital Cancer Center, Tampere, Finland.

PMID: 35847998
DOI: 10.1080/0284186X.2022.2098680

Abstract

Introduction: Treatment with 2-weekly docetaxel 50 mg/m² was shown to improve overall survival and was better tolerated than the standard 75 mg/m² 3-weekly regimen in men with metastatic castration-resistant prostate cancer (mCRPC) in the original randomised PROSTY trial. The aim of this study was to investigate, whether quality of life (QoL) effects would differ between the 2-weekly docetaxel 50 mg/m² regimen from the standard 3-weekly 75 mg/m² treatment.

Materials and methods: QoL data were collected with the Functional Assessment of Cancer Therapy - Prostate (FACT-P) and Functional Assessment of Cancer Therapy Advanced Prostate Symptom Index - 8 Item version (FAPSI-8). Pain was measured using the Visual Analogue Scale (VAS). A total of 743 forms from 163 patients were analysed in Arm A (2-weekly docetaxel), and 704 forms from 173 patients were analysed in Arm B (3-weekly docetaxel). The data were analysed using both the Wilcoxon signed rank test (with Holm-Bonferroni adjustment) and Mann-Whitney U models.

Results: No major differences were found in total QoL. Total QoL was higher at month 8 in Arm B (p = .020), but this was reversed in the following month (p = .043), and no statistically significant differences were found during other months. Compared to Arm A, participants in Arm B had longer-lasting deterioration in FAPSI-8 scores and emotional well-being subdomain at the beginning of treatment (p < .05). Various one-month differences were found in FACT-P subdomains (except for functional well-being), and these favoured participants in Arm A, except for the prostate-cancer subdomain. There were no differences in pain.

Conclusion: Based on our results, 2-weekly docetaxel was not inferior to 3-weekly docetaxel in terms of total health-related QoL and seemed to be superior at least in terms of the FAPSI-8 and emotional well-being subdomain in the first three to four months of treatment. More research on the topic is suggested to confirm the results.

Keywords: Prostate cancer; docetaxel; metastatic castration-resistant prostate cancer; metastatic prostate cancer; quality of life.

Publication types

Clinical Trial, Phase III
Randomized Controlled Trial

MeSH terms

Docetaxel
Humans
Male
Pain
Prostatic Neoplasms, Castration-Resistant* / pathology
Quality of Life*
Treatment Outcome

Substances

Docetaxel