Advertisement
Research Paper| Volume 14, ISSUE 1, 101411, January 2023

Predictive factors for tolerance to taxane based chemotherapy in older adults affected by metastatic prostate cancer (ANCHISES-NCT05471427): A prospective observational trial including patients with metastatic hormone sensitive and castrate resistant prostate cancer treated with taxane chemotherapy

Published:December 08, 2022DOI:https://doi.org/10.1016/j.jgo.2022.11.010
Predictive factors for tolerance to taxane based chemotherapy in older adults affected by metastatic prostate cancer (ANCHISES-NCT05471427): A prospective observational trial including patients with metastatic hormone sensitive and castrate resistant prostate cancer treated with taxane chemotherapy
Previous ArticleClinical analysis of percutaneous kyphoplasty for spinal metastases in older adults with comorbidities
Next ArticleClinical outcome of nivolumab in older and frail patients with recurrent/metastatic head and neck squamous cell carcinoma

      Abstract

      Introduction

      Taxane-based chemotherapy is one of the main cornerstones for treatment of metastatic prostate cancer (mPCa). In aged and well-fit patients, an indication for taxane chemotherapy should remain similar to the general population. Aiming to explore predictive factors of fitness to taxane chemotherapy in older adult patients, a prospective observational study was carried out in our institution.

      Materials and methods

      We collected data from a prospective mono-centric database of patients aged ≥70 years old that were treated in our department. All patients underwent taxane treatment (either docetaxel or cabazitaxel, the latter only in second line setting) starting with standard treatment schedules (75 mg/m2 or 25 mg/m2 every three weeks, respectively). Data about G8 score post treatment decreases were collected and reported. We explored associations between baseline age, G8 score, and Charlson Comorbidity Index (CCI) with taxane dose reduction (DR), treatment temporary suspension (TS), or definitive interruption (TDI). Logistic regression analysis was performed to explore potential predictive factors for tolerability in patients treated with docetaxel.

      Results

      One hundred-eighteen patients underwent taxane chemotherapy between 2011 and 2022, the majority of cases in metastatic castrate resistant prostate cancer (mCRPC) setting (85.6%). In the overall population, DR was performed in 40.7% of cases, and TS and TDI were deemed necessary in 28% and 22.9% of patients, respectively. Forty-seven percent of patients reported a significant deterioration in terms of G8 score (from > to ≤14). Sixty-two percent of the overall population were deemed fit for further treatment after taxane chemotherapy. Rate of DR, TS, and TDI was 29.4%, 11.8% and 9.2% in the docetaxel subgroup, vs 48%, 60% and 12% of patients treated with cabazitaxel, respectively. Lower baseline G8 was reported as a continuous variable and the only independent predictive factor for TDI in docetaxel subgroup (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.25–0.68, p = 0.0008).

      Discussion

      Our data suggest that tolerability of taxane regimens in a pre-treated population of older patients with prostate cancer is acceptable, despite a non-negligible rate of TDI. Taxane chemotherapy should not be denied a priori in order to avoid undertreatment of older adult patients.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Geriatric Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Berthold D.R.
        • Pond G.R.
        • Soban F.
        • de Wit R.
        • Eisenberger M.
        • Tannock I.F.
        Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: updated survival in the TAX 327 study.
        J. Clin. Oncol. 2008 Jan 10; 26 ([PMID: 18182665]): 242-245https://doi.org/10.1200/JCO.2007.12.4008
        View in Article
        • De Bono J.S.
        • Oudard S.
        • Ozguroglu M.
        • Hansen S.
        • Machiels J.P.
        • Kocak I.
        • et al.
        TROPIC investigators. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial.
        Lancet. 2010 Oct 2; 376 ([PMID: 20888992]): 1147-1154https://doi.org/10.1016/S0140-6736(10)61389-X
        View in Article
        • Kyriakopoulos C.E.
        • Chen Y.H.
        • Carducci M.A.
        • Liu G.
        • Jarrard D.F.
        • Hahn N.M.
        • et al.
        Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized Phase III E3805 CHAARTED trial.
        J. Clin. Oncol. 2018 Apr 10; 36 (Epub 2018 Jan 31. PMID: 29384722; PMCID: PMC5891129): 1080-1087https://doi.org/10.1200/JCO.2017.75.3657
        View in Article
        • James N.D.
        • Sydes M.R.
        • Clarke N.W.
        • Mason M.D.
        • Dearnaley D.P.
        • Spears M.R.
        • et al.
        STAMPEDE investigators. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial.
        Lancet. 2016 Mar 19; 387 (Epub 2015 Dec 21. PMID: 26719232; PMCID: PMC4800035): 1163-1177https://doi.org/10.1016/S0140-6736(15)01037-5
        View in Article
        • Gravis G.
        • Fizazi K.
        • Joly F.
        • Oudard S.
        • Priou F.
        • Esterni B.
        • et al.
        Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial.
        Lancet Oncol. 2013 Feb; 14 (Epub 2013 Jan 8. PMID: 23306100): 149-158https://doi.org/10.1016/S1470-2045(12)70560-0
        View in Article
        • Smith M.R.
        • Hussain M.
        • Saad F.
        • Fizazi K.
        • Sternberg C.N.
        • Crawford E.D.
        • et al.
        ARASENS trial investigators. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer.
        N. Engl. J. Med. 2022 Mar 24; 386: 1132-1142
        View in Article
        • Boyle H.J.
        • Alibhai S.
        • Decoster L.
        • Efstathiou E.
        • Fizazi K.
        • Mottet N.
        • et al.
        Updated recommendations of the International Society of Geriatric Oncology on prostate cancer management in older patients.
        Eur. J. Cancer. 2019 Jul; 116: 116-136
        View in Article
        • Bellera C.A.
        • Rainfray M.
        • Mathoulin-Pélissier S.
        • Mertens C.
        • Delva F.
        • Fonck M.
        • et al.
        Screening older cancer patients: first evaluation of the G-8 geriatric screening tool.
        Ann. Oncol. 2012 Aug; 23: 2166-2172
        View in Article
        • Quan H.
        • Li B.
        • Couris C.M.
        • Fushimi K.
        • Graham P.
        • Hider P.
        • et al.
        Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries.
        Am. J. Epidemiol. 2011; 173: 676-682
        View in Article
        • Horgan A.M.
        • Seruga B.
        • Pond G.R.
        • Alibhai S.M.
        • Amir E.
        • De Wit R.
        • et al.
        Tolerability and efficacy of docetaxel in older men with metastatic castrate-resistant prostate cancer (mCRPC) in the TAX 327 trial.
        J. Geriatr. Oncol. 2014 Apr; 5: 119-126
        View in Article
        • Della Pepa C.
        • Cavaliere C.
        • Rossetti S.
        • Di Napoli M.
        • Cecere S.C.
        • Crispo A.
        • et al.
        Predictive comprehensive geriatric assessment in elderly prostate cancer patients: the prospective observational scoop trial results.
        Anti-Cancer Drugs. 2017 Jan; 28: 104-109
        View in Article
        • Kongsted P.
        • Svane I.M.
        • Lindberg H.
        • Sengeløv L.
        Predictors of chemotherapy-induced toxicity and treatment outcomes in elderly versus younger patients with metastatic castration-resistant prostate cancer.
        Clin. Genitourin Cancer. 2016 Dec; 14: e559-e568
        View in Article
        • Gerritse F.L.
        • Meulenbeld H.J.
        • Roodhart J.M.
        • van der Velden A.M.
        • Blaisse R.J.
        • Smilde T.J.
        • et al.
        NePro Study Investigators. Analysis of docetaxel therapy in elderly (≥70 years) castration resistant prostate cancer patients enrolled in the Netherlands prostate study.
        Eur. J. Cancer. 2013 Oct; 49: 3176-3183
        View in Article
        • Maia M.C.
        • Pereira A.A.L.
        • Lage L.V.
        • Fraile N.M.
        • Vaisberg V.V.
        • Kudo G.
        • et al.
        Efficacy and safety of docetaxel in elderly patients with metastatic castration-resistant prostate Cancer.
        J. Glob. Oncol. 2018 Sep; 4 ([Epub 2017 Mar 27. PMID: 30241182; PMCID: PMC6180794]): 1-9https://doi.org/10.1200/JGO.2016.007807
        View in Article
        • Shayegan B.
        • Wallis C.J.D.
        • Hamilton R.J.
        • Morgan S.C.
        • Cagiannos I.
        • Basappa N.S.
        • et al.
        Real-world utilization and outcomes of docetaxel among older men with metastatic prostate cancer: a retrospective population-based cohort study in Canada.
        Prostate Cancer Prostatic Dis. 2022 Feb 23; https://doi.org/10.1038/s41391-022-00514-9
        View in Article
        • Italiano A.
        • Ortholan C.
        • Oudard S.
        • Pouessel D.
        • Gravis G.
        • Beuzeboc P.
        • et al.
        Docetaxel-based chemotherapy in elderly patients (age 75 and older) with castration-resistant prostate cancer.
        Eur. Urol. 2009 Jun; 55: 1368-1375
        View in Article
        • Takaha N.
        • Okihara K.
        • Kamoi K.
        • Hongo F.
        • Iwata T.
        • Yano K.
        • et al.
        Feasibility of tri-weekly docetaxel-based chemotherapy for elderly patients (age 75 and older) with castration-resistant prostate cancer.
        Urol. Int. 2011; 87: 263-269
        View in Article
        • Wang K.Y.
        • Ma L.
        • Zhang L.L.
        • Hu Y.C.
        • Jiang J.H.
        • Ma Q.
        Efficacy and safety of docetaxel and prednisolone chemotherapy in very elderly men with metastatic castration-resistant prostate cancer (mCRPC) in real world: a single institute experience.
        Ann. Palliat. Med. 2021 Feb; 10: 1438-1444
        View in Article
        • Kellokumpu-Lehtinen P.L.
        • Harmenberg U.
        • Joensuu T.
        • McDermott R.
        • Hervonen P.
        • Ginman C.
        • et al.
        PROSTY study group. 2-weekly versus 3-weekly docetaxel to treat castration-resistant advanced prostate cancer: a randomised, phase 3 trial.
        Lancet Oncol. 2013 Feb; 14 ([Epub 2013 Jan 4. PMID: 23294853]): 117-124https://doi.org/10.1016/S1470-2045(12)70537-5
        View in Article
      20. https://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf
        View in Article
        • Sternberg C.N.
        • Castellano D.
        • de Bono J.
        • Fizazi K.
        • Tombal B.
        • Wülfing C.
        • et al.
        Efficacy and safety of Cabazitaxel versus Abiraterone or enzalutamide in older patients with metastatic castration-resistant prostate cancer in the CARD study.
        Eur. Urol. 2021 Oct; 80: 497-506
        View in Article
        • Alibhai S.M.H.
        • Breunis H.
        • Hansen A.R.
        • Gregg R.
        • Warde P.
        • Timilshina N.
        • et al.
        Examining the ability of the Cancer and aging research group tool to predict toxicity in older men receiving chemotherapy or androgen-receptor-targeted therapy for metastatic castration-resistant prostate cancer.
        Cancer. 2021 Jul; 127: 2587-2594
        View in Article

      Article info

      Publication history

      Published online: December 08, 2022
      Accepted: November 30, 2022
      Received in revised form: November 2, 2022
      Received: August 10, 2022

      Identification

      DOI: https://doi.org/10.1016/j.jgo.2022.11.010

      Copyright

      © 2022 Published by Elsevier Ltd.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX