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

ObjectiveBased 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 methodsWe reviewed the charts of all mCRPC patients treated with DTX 30 mg/m2 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.ResultsIn 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.ConclusionFor Taiwanese mCRPC patients, weekly DTX 30 mg/m2 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.