YOUNG PATIENTS WITH mCRPC

Urol Oncol. 2015 Apr 20. pii: S1078-1439(15)00108-8. doi: 10.1016/j.urolonc.2015.02.016. [Epub ahead of print]

Clinical outcomes in a contemporary series of "young" patients with castration-resistant prostate cancer who were 60 years and younger.

Caffo O1, Ortega C2, Di Lorenzo G3, Sava T4, De Giorgi U5, Cavaliere C6, Macrini S7, Spizzo G8, Aieta M9, Messina C10, Tucci M11, Lodde M12, Mansueto G13, Zucali PA14, Alesini D15, D׳Angelo A16, Massari F17, Morelli F18, Procopio G19, Ratta R20, Fratino L21, Lo Re G22, Pegoraro MC23, Zustovich F24, Vicario G25, Ruatta F2, Federico P3, La Russa F4, Burgio SL5, Maines F26, Veccia A26, Galligioni E26.

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Abstract

BACKGROUND: 

The prognosis of younger patients with prostate cancer is unclear, and the very few studies assessing those with metastatic castration-resistant prostate cancer (mCRPC) have mainly involved patients treated with older therapies. The aim of this observational study was to evaluate the clinical outcomes of a contemporary series of docetaxel-treated patients with mCRPC who were 60 years and younger.

PATIENTS AND METHODS: 

We retrospectively identified 134 patients who were 60 years and younger who were treated with docetaxel in 25 Italian hospitals and recorded their predocetaxel history of prostate cancer, their characteristics at the start of chemotherapy, and their postdocetaxel treatment history and outcomes.

RESULTS: 

Most of the 134 consecutive patients with mCRPC received the standard 3-week docetaxel schedule; median progression-free survival (PFS) was 7 months, and 90 patients underwent further therapies after progression. The median overall survival (OS) from the start of docetaxel treatment was 21 months, but OS was significantly prolonged by the postprogression treatments, particularly those based on the new agents such as cabazitaxel, abiraterone acetate, or enzalutamide. OS was significantly shorter in the patients with a shorter interval between the diagnosis of prostate cancer and the start of docetaxel treatment; those who received hormonal treatment for a shorter period; those with shorter prostate-specific antigen doubling times; and those with lower hemoglobin levels, a worse performance status, and higher lactate dehydrogenase levels before starting treatment with docetaxel.

CONCLUSIONS: 

The findings of this first study of clinical outcomes in a contemporary series of younger patients with mCRPC showed that their survival is similar to that expected in unselected patients with mCRPC who were of any age.