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Comparison of 2-Weekly and 3-Weekly Dosing of Docetaxel in Metastatic Prostate Cancer

Published:February 23, 2022DOI:https://doi.org/10.1016/j.clgc.2022.02.009

      Highlights

      • Docetaxel is the standard chemotherapy treatment in metastatic prostate cancer.
      • Tolerance is an issue of concern in 3-weekly docetaxel schemes.
      • A 2-weekly docetaxel scheme may be as effective as a 3-weekly scheme.
      • A 2-weekly scheme may be more suitable for older and more comorbid patients.

      Abstract

      Introduction

      Docetaxel 75 mg/m2 every 3 weeks is the standard schedule for metastatic prostate cancer (mPC). Alternative dosing of 50 mg/m2 every 2 weeks may be an option for frail patients. Our aim is to define which factors influence the choice of schedule and to compare the outcomes of both schedules in daily clinical practice.

      Patients and Methods

      We retrospectively included patients with mPC treated with docetaxel in our institution. We compared data from patients treated with 3-weekly, 75 mg/m2 docetaxel or 2-weekly, 50 mg/m2 docetaxel, including basal characteristics, predefined prognostic factors, treatment received, toxicity and survival data.

      Results

      We included 200 patients, 86% of whom presented castration resistant mPC. A total of 158 patients (79%) were treated with 3-weekly scheme. Compared with these patients, patients treated with 2-weekly scheme were significantly older, had higher Eastern Cooperative Oncology Group performance status (ECOG PS) and Charlson Comorbidity Index, presented more visceral metastases and needed opioid treatment more frequently. Patients treated with 2-weekly scheme presented shorter median overall survival; however, these differences were not shown after multivariate analysis with significant prognostic factors. Patients treated with 2-weekly scheme had more treatment delays and suspensions, but less clinically impairing toxicities such as febrile neutropenia, neuropathy and diarrhea; toxic deaths were 5 in the 3-weekly group while none in the 2-weekly group.

      Conclusion

      Compared to docetaxel 75 mg/m2 every 3 weeks, dosing of 50 mg/m2 every 2 weeks may be an alternative for older, frailer and more comorbid patients. Two-weekly dosing may be used more frequently in selected patients.

      Keywords

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