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Due to start docetaxel chemotherapy, then Zytiga (abiraterone). How long will I last?

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Due to start docetaxel chemotherapy, then Zytiga (abiraterone). How long will I last?

[if you are at an earlier stage in your disease, you may wish to visit:
Had radiation, or surgery then radiation, but my PSA has started rising – how long will I last?]

Jim Marshall (not a doctor) said ...
Men are often frustrated when their doctor gives them a real answer – "Nobody knows!" or "Many men are alive many years later".

Each man's pathway to this point is different.

  • Some may have had a radical primary treatment like surgery or radiation.
  • Most will have had a primary hormone therapy (ADT), with a single drug like Zoladex, Eligard or Lucrin injection or implant.
  • Some men will have had a second or third hormone therapy drug added to this primary hormone therapy.
  • Some men will then have moved on to secondary hormone therapies. Others miss this stage because their PSA is rising too fast.

But at some stage, your PSA starts rising too fast. Your doctor checks your testosterone to see that the drugs really have been taking away enough testosterone. If it is, your doctor may order chemotherapy, and tells you that after this you will have Zytiga (abiraterone).

We don't know how long you will last.
All we can say is the time at which half the men on this combination were still alive. That's called the median.
We can't say when all of them died, because at last report, some men on one trial (not sure whether it was this one, or not) were still alive 8 years after starting Zytiga (abiraterone).

So, if you look at my summary of the results table below, you will see:

  • Half the men were still alive more than two and a half years after beginning docetaxel (32.6 months).
  • Half the men who stopped docetaxel because it did not work, or stopped working, were still alive more than a year after that (14.2 months).
  • Half the men who stopped docetaxel because they successfully finished their course, or gave up because of bad side effects were still alive nearly a year and a half later (17 months).

You may increase your odds of being in this second half by looking after your general health, especially your heart with good eating, and good (doctor advised) exercise.

... end Jim



 

 


Exploratory analysis of survival benefit and prior docetaxel (D) treatment in COU-AA-301Exploratory analysis of survival benefit and prior docetaxel (D) treatment in COU-AA-301, a phase III study of abiraterone acetate (AA) plus prednisone (P) in metastatic castration-resistant prostate cancer (mCRPC).
Sub-category: Prostate Cancer
Category: Genitourinary Cancer
Meeting: 2012 Genitourinary Cancers Symposium
Session Type and Session Title: General Poster Session A: Prostate Cancer
Abstract No: 15
Citation: J Clin Oncol 30, 2012 (suppl 5; abstr 15)

Kim N. Chi, Howard I. Scher, Arturo Molina, Christopher Logothetis, Robert J. Jones, John Staffurth, Scott A. North, Nicholas J. Vogelzang, Fred Saad, Paul N. Mainwaring, Stephen John Harland, Jinhui Li, Thian San Kheoh, Christopher M. Haqq, Karim Fizazi; British Columbia Cancer Agency, Vancouver, BC, Canada; Memorial Sloan-Kettering Cancer Center, New York, NY; Ortho Biotech Oncology Research and Development, Los Angeles, CA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Institute of Cancer Sciences, Glasgow, United Kingdom; Cardiff University, Velindre Hospital, Cardiff, United Kingdom; Cross Cancer Institute, Edmonton, AB, Canada; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; University of Montreal Hospital Center, Montreal, QC, Canada; Haematology and Oncology Clinics of Australasia, Milton, Australia; University College London Cancer Institute, London, United Kingdom; Johnson & Johnson Pharmaceutical Research & Development, Raritan, NJ; Institut Gustave Roussy, University of Paris Sud, Villejuif, France
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^) here and in the printed Proceedings.
Abstract Disclosures
2012 GU Proceedings Erratum
Abstract:
Background: AA, a selective androgen biosynthesis inhibitor, blocks the action of CYP17, thereby inhibiting adrenal and intratumoral androgen synthesis. AA has demonstrated improved overall survival (OS) by 4.6 months (mos) vs placebo (HR=0.74) in patients (pts) previously treated with D. Methods: COU-AA-301 is a randomized double-blind study of AA (1 g) + P (5 mg po BID) vs placebo + P administered to mCRPC pts post-D with a primary endpoint of OS. To evaluate the robustness of the primary survival results, we performed post hoc exploratory analyses to assess whether the timing of first and last dose of D and reason for D discontinuation impacted OS. Results: At the time of randomization, treatment arms were balanced with respect to baseline characteristics, prior D use, and reasons for discontinuation. In both arms, almost half (45%) discontinued D due to progressive disease (PD); the remainder discontinued D as part of planned treatment (37%), toxicity (12%), or for other reasons (5%) per investigator reporting. Median OS from first and last dose of D were longer with AA vs placebo (Table). Median OS was longer with AA vs placebo in pts who discontinued D for PD or for all other reasons. Conclusions: These exploratory analyses suggest that the survival benefit of AA in mCRPC was maintained when calculated from first or last dose of prior D, and whether or not pts discontinued D for PD. Pts in the AA arm of this study had a prolonged median OS of > 32 mos from the time of initial D therapy. Congruity among these analyses demonstrates the robustness of the primary survival result.

Jim Marshall (not a doctor) said ...

This is a short summary of the included table:

abiraterone (N=797) placebo (N=398)
 Median survival from first dose Docetaxel abiraterone - 32.6 months, placebo - 27.6 months
 Median survival from last dose Docetaxel abiraterone - 23.2 months, placebo - 19.4 months
Reason for Docetaxel discontinuation
 Progressive Disease abiraterone - 14.2 months, placebo - 10.5 months
 All other reasons abiraterone17.0 months- placebo - 12.6 months

The summary has been prepared by a person with no medical training.
See the actual article here. (Enter 15 in the Abstract number in the search box):
Exploratory analysis of survival benefit and prior docetaxel (D) treatment in COU-AA-301
... end Jim

 

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