Quality of Life With Chemohormonal Treatment in Prostate Cancer
In the E3805 trial reported in the Journal of Clinical Oncology, Morgans et al found that chemohormonal therapy with docetaxel and androgen-deprivation therapy (ADT) was associated with poorer quality of life (QOL) at 3 months but better QOL at 12 months vs ADT alone in metastatic hormone-sensitive prostate cancer. Chemohormonal therapy has been shown to improve overall survival vs ADT alone in this setting.
Study Details
In the trial, 790 men were randomized between July 2006 and December 2012 to receive docetaxel for 6 cycles plus ADT (n = 397) or ADT alone (n = 393). QOL was assessed with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) instrument at 3, 6, 9, and 12 months. Completion rates were 90% at baseline, 86% at 3 months, 83% at 6 months, 78% at 9 months, and 77% at 12 months.
QOL Changes
Compared with baseline, patients in the chemohormonal therapy group had a significant decline in FACT-P at 3 months (P < .001) but not at 12 months (P = .38). Compared with patients in the ADT alone group, those in the chemohormonal therapy group had significantly worse FACT-P scores at 3 months (P = .02) but significantly better scores at 12 months (P = .04). Differences between groups in FACT-P never exceeded the prespecified minimal clinically important difference. Patients in the chemohormonal therapy group had significantly poorer Functional Assessment of Chronic Illness Therapy-Fatigue scores at 3 months vs the ADT alone group (P < .001), with scores being similar between groups at all other time points. Compared with baseline, both groups had significantly poorer FACT-Taxane scores over time (P < .001). No significant differences were observed between groups in Brief Pain Inventory scores over time.
The investigators concluded, “Although ADT + [docetaxel] was associated with statistically worse QOL at 3 months, QOL was better at 12 months for ADT + [docetaxel] patients than for ADT patients. Both arms reported a similar minimally changed QOL over time, suggesting that ADT + [docetaxel] is not associated with a greater long-term negative impact on QOL.”
The study was supported by National Cancer Institute grants and a grant from Sanofi.
Alicia K. Morgans, MD, MPH, of Northwestern University Feinberg School of Medicine, is the corresponding author for the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
