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


1 Department of Medical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
2 Department of Clinical Research, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India
3 Department of Surgical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi, India

Correspondence Address:
Alok Gupta,
Departments of Medical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, Saket, New Delhi - 110 017
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_342_19

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.


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    -  Gupta A
    -  Hussain SM
    -  Sonthwal N
    -  Chaturvedi H
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