Docetaxel‐based chemotherapy with zoledronic acid and prednisone in hormone refractory prostate cancer: Factors predicting response and survival

Abstract

Objectives:To evaluate the efficacy of docetaxel/prednisone and zoledronic acid in hormone refractory prostate cancer (HRPC) patients and to analyze prognostic factors predicting overall survival. Methods: Forty-four HRPC patients were given docetaxel (75 mg/m 2 ), prednisone and zoledronic acid (4 mg) every three weeks. Overall and progression-free survival curves were calculated. Using the log-rank test, variables predicting overall survival (age, Gleason score, baseline prostate-specific antigen [PSA], percentage PSA decline, nadir PSA, number of chemotherapy cycles) were calculated. Results: Median age was 66 years and mean PSA 171.25 ng/mL. The average number of given cycles was 6.3. A good PSA response (>50% decline) was observed in 26/44 cases (59.1%). A total of 17/44 (38.6%) patients expired with a median overall survival of 62.4 weeks. Patients with a Gleason score less than 7, who received more than four cycles and with a more-than-50% decline in PSA had significantly better survival. Variables like age, baseline PSA and nadir PSA did not significantly affect survival. Conclusion:The combination of docetaxel/zoledronic/prednisone is safe and effective in the management of HRPC. Patients with a Gleason score <7, PSA decline >50% and those who receive more than four cycles have significantly better survival.

High-Dose Calcitriol, Docetaxel and Zoledronic Acid in Patients with Castration-Resistant Prostate Cancer: A Phase II Study

“…The use of zoledronic acid in treating prostate cancer patients is imperatively rational knowing that most of these patients present with skeletal involvement, in addition to the demonstrated antitumor effects of zoledronic acid [9]. Zoledronic acid is the only bisphosphonate that has demonstrated a statistically significant reduction in skeletal morbidity in CRPC patients [24].…”

“…In clinical trials, high-dose calcitriol has shown good response rates in combination with docetaxel [8]. Zoledronic acid, a known bisphosphonate, has antitumor activity, and it has also been used with docetaxel in treating CRPC with good efficacy [9]. …”

Docetaxel with or without zoledronic acid for castration-resistant prostate cancer

“…All of them suffered symptomatic bone progression before their death, 40 (75.5 %) in the Group A and 45 (86.5 %) in the Group B. The median overall survival time was 19 months (95 % CI, [16][17][18][19][20][21][22] and 15 months (95 % CI, [12][13][14][15][16][17][18][19], respectively (P = 0.02).…”

“…Therefore, its inclusion into a regular regimen with docetaxel holds a strong case, particularly because its synergistic effects with docetaxel which may result in different mechanism of induction of apoptosis in cancerous cells [20][21][22]. Meanwhile, bisphosphonates also have by themselves shown an improved overall survival advantage when used in CRPC [11][12][13]. Jaw osteonecrosis 0 (0) 0 (0)…”

“…ZA, as a third generation of bisphosphonates, can not only prevent osteoclastic activity and bone lysis but also inhibit angiogenesis and promoting the apoptosis of cancerous cells. Preclinical and clinical studies also indicated that ZA has anticancer activity which may delay disease progression [12,13]. Even though previous researches had been done to explore clinical benefits of ZA in CRPC patients, they were either respective studies not combined with docetaxel-base chemotherapy or only a few case number in a single arm.…”