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Taxotere (docetaxel) chemotherapy every 3 weeks most beneficial to GS 7-10


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Jim Marshall (not a doctor) said ... 

These researchers looked back through the data collected for another study.


They looked at men who had been given Taxotere (docetaxel) chemotherapy every 3 weeks.


They found that the docetaxel chemotherapy was most beneficial to men who had an initial Gleason score of 7, 8, 9 or 10. It increased their average survival by about 4 months. It increased the average survival from 14.5 months to 18.9 months.


They found that the docetaxel chemotherapy was less beneficial to men who had an initial Gleason score of 6 or less. The average survival for this group was only increased by about a month, from 20.7 months to 21.6 months.


Your doctor will not set great store by this result:

  • It was not a published paper subjected to professional critique – just a poster at a conference.
  • It was not a study that was started to find this out by putting half the men in one group, half in the other (a prospective study). It looked backwards through data collected for another purpose (a retrospective study).

But your doctor may use this to guide them when they advise you.

... end Jim


The initial biopsy Gleason score as a predictive marker for docetaxel survival benefit in patients with prostate cancer: Data from the TAX 327 study.

2013 Genitourinary Cancers Symposium

General Poster Session A: Prostate Cancer

J Clin Oncol 31, 2013 (suppl 6; abstr 44)


Robert van Soest, Ellen de Morrée, Liji Shen, Ian Tannock, Mario A. Eisenberger, Ronald De Wit; Erasmus University Medical Center, Rotterdam, Netherlands; Sanofi, Malvern, PA; Princess Margaret Hospital, Toronto, ON, Canada; The Johns Hopkins Medical Institutions, Baltimore, MD

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.




Background: The TAX 327 study was conducted in 1,006 men with metastatic castration-resistant prostate cancer (mCRPC) who were randomized to receive 3-weekly docetaxel (D3), weekly docetaxel (D1) or 3-weekly mitoxantrone (M), each with prednisone. Survival and symptom control were superior following D3 as compared to M. In this post-hoc analysis we aimed to identify factors that could characterize subgroups of patients who obtained the greatest benefit from the use of D3 as compared to M.


Methods: The TAX 327 database was used to investigate if patients with poorly differentiated tumors (Gleason 7-10) at diagnosis had greater benefit from D3 as compared to M, than patients with better differentiated tumors (Gleason ≤6). Using a Cox model, we compared overall survival (OS) between the treatment groups within each subgroup of Gleason score.


Results: Baseline characteristics known to predict OS including visceral metastasis and time from first hormonal treatment to the start of chemotherapy were well balanced between patient groups, except for an imbalance in the small group of patients with impaired Karnofsky performance score (PS) (see table). The TAX 327 data showed that the OS benefit of D3 versus M is greater in patients with high grade tumors (median OS 18.9 vs 14.5 months) than in patients with low grade tumors (median OS 21.6 vs 20.7 months).


Conclusions: The survival benefit obtained with docetaxel as compared to mitoxantrone is greater in patients with high Gleason score tumors. Although this finding is hypothesis-generating and needs confirmation in other trials, it may provide additional guidance in treatment decisions regarding the use of chemotherapy as first line treatment for patients with mCRPC. 
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