Weekly low-dose docetaxel is an effective treatment with fewer adverse events for metastatic castration-resistant prostate cancer in Taiwanese patients

Objective: Based on the TAX 327 Phase III trial, docetaxel (DTX)-based chemotherapy is the standard first-line treatment for metastatic castration-resistant prostate cancer (mCRPC). However, some heterogeneity is observed in clinical practice. The present study aimed to evaluate the outcomes of a weekly low-dose DTX regimen, which is clinical practice at our institution, and to compare it with the standard triweekly DTX use in the TAX 327 trial. Materials and methods: We reviewed the charts of all mCRPC patients treated with DTX 30 mg/m(2) weekly on Days 1 and 8 of a 3-week cycle and prednisolone 5 mg twice daily between January 2006 and February 2014 in our hospital. Results: In the first-line setting, 19 patients with mCRPC received weekly DTX chemotherapy. The median four cycles of treatment were given in our cohort. The median follow-up period from the start of chemotherapy was 27.9 months (range 5.4-67.2months). The prostate-specific antigen (PSA) response rate was 47.3%, and the median overall survival was 15.8 months (range 1.2-34.5 months). The main toxicities were anemia (57%), fatigue (26%), and neuropathy (10%). Two patients had different Grade 3 to 4 adverse events (neutropenia and anemia). Our results revealed initial PSA < 100 ng/mL, long duration (> 12 months) of response to primary hormone therapy, rechallenge, and a higher accumulation dose of DTX were associated with good prognosis. Conclusion: For Taiwanese mCRPC patients, weekly DTX 30 mg/m(2) is an efficient regimen for disease control with relatively low Grade 3 or 4 hematological adverse effects. The proper treatment duration of DTX therapy for mCRPC in Taiwanese patients is still uncertain, so further research is needed. Copyright (C) 2015, Taiwan Urological Association.