ADT + DOC was adopted as the norm for care in MHSPC. Clinical studies CHAARTED and STAMPEDE combined 6 cycles of DOC with ADT for induction, whereas GETUG-AFU-15 employed 9 cycles of DOC. Early DOC usage in relation to ADT beginning was thought to be preferable. Individual patient (pt) data from CHAARTED and GETUG-AFU-15 data were subjected to a meta-analysis.

Following the completion of data transfer agreements, data were gathered from NCI (CHAARTED) and the UNICANCER (GETUG). In order to examine the results, researchers divided the group into 2 categories based on the load (high/HV vs low volume/LV) and prior local definitive treatment (PLT) (Y vs N) and analyzed outcomes by start of DOC < 35 days (d) or ≥35 d of randomization. Patients from both studies who received ADT + DOC were included. In both univariate and multivariate models, the effect of these 3 covariates, adjusted for age, on OS was examined using a Cox proportional hazards model stratified by the procedure. The Kaplan-Meir formula was used to get the median OS.

For possible relationships between the timing of docetaxel treatment, the severity of the illness, and previous local therapy, an ECOG 3805/GETUG meta-analysis was done. About 319 pts and 332 pts, respectively, commenced the DOC in ≥35 d (CHAARTED, n=470, and GETUG, n=181) and <35 d of the ADT respectively. Shorter time to DOC, LV, and PLT were significant predictors of prolonged OS, according to a univariate analysis. According to multivariate analysis, HV patients with PLT (HVY) had a longer OS than HV patients without PLT (HVN) (P=0.015). Time to DOC in days was correlated with the volume of the tumor (P=0.06) and previous local therapy (P<0.001). When compared to the no local treatment group (HV 44.6 vs LV 40.3 days), the average number of days until DOC was shorter in the group of patients who had PLT in both the HV and LV categories (HV 31.6 vs LV 25.5 days).

According to the meta-analysis, patients with MHSPC who get ADT + DOC had less illness and benefit from PLT. After accounting for known significant prognostic variables, earlier DOC usage was not linked to improved survival.

Reference: annalsofoncology.org/article/S0923-7534(22)03354-3/fulltext