Efficacy of carboplatin-taxane combinations in the management of castration-resistant prostate cancer: a pooled analysis of seven prospective clinical trials
Autor: | Meredith M. Regan, William Oh, S. Urakami, Wm. Kevin Kelly, Susan Halabi, Elizabeth O'Donnell, N. Kikuno, William R. Berry |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2010 |
Předmět: |
Bridged-Ring Compounds
Male Oncology medicine.medical_specialty endocrine system diseases medicine.medical_treatment urologic and male genital diseases Carboplatin carboplatin estramustine prostate cancer taxanes chemistry.chemical_compound Prostate cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Castration Treatment Failure neoplasms Aged Gynecology Clinical Trials as Topic Chemotherapy Taxane business.industry Prostatic Neoplasms Cancer Original Articles Hematology Middle Aged medicine.disease Chemotherapy regimen female genital diseases and pregnancy complications Prostate-specific antigen Treatment Outcome chemistry Docetaxel Taxoids business therapeutics medicine.drug |
Zdroj: | ANNALS OF ONCOLOGY. 21(2):312-318 |
ISSN: | 0923-7534 |
Popis: | Background Docetaxel is associated with prolonged survival in castration-resistant prostate cancer (CRPC). Platinum compounds have modest but distinct single-agent activity. Carboplatin may have greatest potential for benefit when combined with taxanes. We investigated whether there is a subset of patients with CRPC for whom the efficacy of combination taxane–estramustine–carboplatin (TEC) chemotherapy may be greatest. Patients and methods Individual patient data (n = 310) were obtained from seven trials using TEC chemotherapy. Prostate-specific antigen (PSA) response was defined as ≥50% post-therapy decline from baseline. Overall survival was defined from baseline to death from any cause. Logistic and Cox regression were used to investigate heterogeneity in outcome to TEC by patient and disease characteristics. Predicted survival probabilities were calculated from the Halabi Cancer and Leukemia Group B (CALGB) nomogram. Results The pooled PSA response proportion was 69% [95% confidence interval (CI) 56% to 80%]. There was no evidence of differential PSA response by disease characteristics. Established prognostic factors were associated with survival. The pooled 12-month survival estimate of 79% (95% CI 71% to 84%) was higher than the median 59% 12-month nomogram-predicted survival. Conclusions TEC chemotherapy has significant clinical activity in CRPC. A randomized, controlled trial evaluating the addition of carboplatin to taxane-based chemotherapy is needed to elucidate the value of carboplatin in CRPC. |
Databáze: | OpenAIRE |
Externí odkaz: |