First-Line Docetaxel Improves QoL, Proves Cost-Effective in Prostate Cancer
The addition of docetaxel to first-line long-term hormone therapy in prostate cancer improves overall health-related quality of life, reduces the need for further therapy, and is cost effective, according to a presentation to be given at the 2018 Genitourinary Cancers Symposium (February 8-10, 2018; San Francisco, CA).
Large randomized controlled trials have demonstrated the ability of docetaxel—when added to standard of care—prolongs survival for men with metastatic prostate cancer and prolongs time to treatment failure for those without metastatic disease.
Researchers from the United Kingdom studied the impact of docetaxel on health-related quality of life, resource use, and cost-effectiveness for men treated in a recent trial (STAMPEDE). The standard of care therapy used in STAMPEDE was hormone therapy for at least 2 years and radiotherapy in some patients. Docetaxel (75 mg/m2) was administered, along with standard of care for six 3-weekly cycles with prednisone (10 mg daily).
Health outcomes and costs were modeled using the EuroQol (EQ-5D) and resource use data were collected within the trial. Lifetime predictions of costs, changes in predictive survival duration, quality adjusted life years, and incremental cost-effectiveness ratios (ICERs) were calculated.
Results of the analysis showed that the addition of docetaxel was expected to extend survival by an average of 0.89 years for patients with metastatic disease and 0.78 years for patients without metastases, compared with those receiving standard of care only. Similarly, docetaxel was estimated to extend discounted quality-adjusted life years by 0.51 years in patients with metastatic disease and 0.39 years for patients without metastases.
Importantly, docetaxel was shown to be cost-effective in patients with metastatic disease (ICER = £5,514/quality-adjusted life years vs standard of care) and in patients without metastases (higher quality-adjusted life years, lower costs vs standard of care).
Results of the analysis led researchers to conclude that docetaxel improves health-related quality of life, delays time to and reduces the need for subsequent therapy, and is cost-effective among patients with both metastatic and non-metastatic prostate cancer. “Clinicians should consider whether the evidence is now sufficiently compelling to support docetaxel use in non-metastatic patients,” they wrote.—Zachary Bessette