Addition of docetaxel or abiraterone to androgen deprivation therapy in metastatic hormone-sensitive prostate cancer in Indian population

摘要

Background: The addition of docetaxel or abiraterone to androgen deprivation therapy (ADT) achieves superior survival outcomes in metastatic hormone-sensitive prostate cancer (mHSPC) in predominantly Western population. We sought to evaluate the treatment outcomes of adding docetaxel or abiraterone to ADT in Indian population. Methods: We reviewed the medical records of ninety patients with newly diagnosed mHSPC who received treatment between January 2015 and June 2018. Patients received ADT alone or ADT docetaxel or ADT abiraterone as initial treatment. Monthly clinical evaluation and prostate-specific antigen (PSA) measurement were done. Outcome measures analyzed included PSA decline 90%, serological complete response (sCR) (PSA 0.2 ng/ml), and progression to CRPC. Outcome variable was compared using Fisher's exact test. Results: Patients received ADT alone (n = 37) or ADT docetaxel (n = 31) or ADT abiraterone (n = 22). The median age was 67.5 years (range, 41–87 years) and the median PSA was 88.5 ng/ml (range, 1.12–4000). PSA decline 90% was seen in 22 (73%), 24 (86%), and 17 (94%) patients in the ADT alone, ADT docetaxel, and ADT abiraterone groups. sCR was achieved in 5 (17%), 10 (36%), and 9 (50%) patients in the ADT alone, ADT docetaxel, and ADT abiraterone groups. Progression to CRPC was observed in 18 (60%), 11 (39%), and 2 (11%) patients in the ADT alone, ADT docetaxel, and ADT abiraterone groups. Conclusion: The addition of docetaxel or abiraterone to ADT achieves a deeper serological response and reduces progression to CRPC compared to ADT alone in mHSPC patients of Indian origin. Longer follow-up is required to comment on overall survival and also to determine which combination (ADT docetaxel or ADT abiraterone) is superior to others, if at all.