title: A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital.
abstract: BACKGROUND
  Based on the TAX 327 phase III trial, docetaxel-based chemotherapy is the standard first-line treatment for hormone-resistant prostate cancer (HRPC); however, there is some heterogeneity in the use of this agent in routine clinical practice. The aim of the present study was to examine the patterns of docetaxel use in routine clinical practice at our institution and to compare them with docetaxel use in the TAX 327 clinical trial.
  
  
  METHODS
  We conducted a retrospective chart review of HRPC patients treated with first-line docetaxel between 2005 and 2007 at the Princess Margaret Hospital.
  
  
  RESULTS
  In the first-line setting, 88 patients with HRPC received docetaxel. The main reasons for initiating docetaxel were rising prostate-specific antigen (PSA, 98%) and progressive symptoms (77%). The PSA response rate was 67%; median time to response was 1.5 months, and duration of response was 6.8 months. Median survival was 15.9 months (95% confidence interval: 12.4 to 20.5 months). Patients received a median of 7 cycles of treatment, and the main toxicities were fatigue (35%) and neuropathy (24%). Post docetaxel, 36 patients received second-line treatment with a 22% response rate.
  
  
  CONCLUSIONS
  In routine clinical practice, HRPC patients received docetaxel mainly because of symptomatic disease progression. Overall response rates and toxicities were comparable to those in the TAX 327 trial. However, our patients received a median of only 7 cycles of treatment versus the 9.5 administered on trial, and survival was slightly shorter in our single-institution study. A larger prospective multicentre analysis, including performance status and quality-of-life parameters, may be warranted to determine if docetaxel performs as well in routine clinical practice as it does in the clinical trial setting.
authors.affiliation: Division of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON.
authors.forename: S N
authors.initials: SN
authors.lastname: Chin
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Moore
authors.forename: S S
authors.initials: SS
authors.lastname: Sridhar
references.citation: J Clin Oncol. 2008 Jan 10;26(2):242-5
references.pmid: 18182665
references.citation: J Oncol Pharm Pract. 2008 Mar;14(1):45-9
references.pmid: 18337440
references.citation: Ann Oncol. 2008 Oct;19(10):1749-53
references.pmid: 18487550
references.citation: N Engl J Med. 2004 Oct 7;351(15):1513-20
references.pmid: 15470214
references.citation: J Clin Oncol. 1999 Nov;17(11):3461-7
references.pmid: 10550143
references.citation: N Engl J Med. 2004 Oct 7;351(15):1502-12
references.pmid: 15470213
references.citation: J Clin Oncol. 1996 Jun;14(6):1756-64
references.pmid: 8656243
references.citation: Eur J Cancer. 2008 Jun;44(9):1193-7
references.pmid: 18448326