Qualitative and Quantitative Assessment of Patient and Carer Experience of Chemotherapy (Docetaxel) in Combination with Androgen Deprivation Therapy (ADT) for the Treatment of Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)

Abstract

IntroductionRecent studies suggest that docetaxel plus androgen deprivation therapy can prolong survival among men with metastatic hormone-sensitive prostate cancer (mHSPC). However, as a cytotoxic therapy, there is a need to understand the experiences of men with mHSPC receiving docetaxel and their carers in a real-world setting.MethodsDuring phase 1, semi-structured qualitative interviews were conducted with men with mHSPC (n = 31) and their carers (n = 14) in Europe to elicit in-depth data concerning their experiences with docetaxel. Eighteen men were also asked to record their experiences in a diary for 7 days. During phase 2, men with mHSPC (n = 161) and carers of men with mHSPC (n = 135) completed an online survey comprising self-report questionnaires including the Cancer Therapy Satisfaction Questionnaire, Brief Fatigue Inventory, Functional Assessment of Cancer Therapy-Prostate, EuroQol-5-Dimensions and the Burden Scale for Family Caregivers (carers only).ResultsAt the outset of therapy, men reported a willingness to take docetaxel to prolong their life, despite being fearful of the potential side effects and impacts on their daily lives. Patient and carer experiences were generally consistent with pre-treatment expectations. However, variations in individual experiences and their ability to tolerate side effects were evident. Fatigue emerged as a prominent symptom with the majority (n = 98, 60.9%) of men reporting experiencing moderate-severe fatigue in the past 24 h. Participant ratings of fatigue were strongly correlated with health-related quality of life (r = − 0.82). Nausea, diarrhoea and sore mouth were also among the most bothersome symptoms for participants.ConclusionsFindings from this study highlight that real-world experience of docetaxel may differ from that observed in clinical trials and that care must be taken to ensure that treatment options are tailored to the needs of individual patients to promote not only how long patients survive but also the quality of that survival.FundingJanssen

Systemic treatment for metastatic castrate resistant prostate cancer: Does seqence matter?

“…Median number of months on 2nd gen ADT (IQR) 17 (11-23) 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) .01…”

“…Docetaxel for prostate cancer has long suffered from an inherent bias against chemotherapy among clinicians and patients. For many years, patients with prostate cancer would die without ever having received this proven, survival and quality of life enhancing therapy . The paradigm began to shift when the CHAARTED and STAMPEDE studies proved that early chemotherapy in the hormone sensitive setting leads to a substantial improvement in overall survival .…”

“…For many years, patients with prostate cancer would die without ever having received this proven, survival and quality of life enhancing therapy. [21][22][23][24] The paradigm began to shift when the CHAARTED and STAMPEDE studies proved that early chemotherapy in the hormone sensitive setting leads to a substantial improvement in overall survival. [25][26][27] In this retrospective study, we investigate the two most common treatment sequences for mCRPC, docetaxel followed by 2nd gen ADT and 2nd gen ADT followed by docetaxel, and investigate whether the benefit of earlier chemo in the hormonesensitive setting holds true in the castration resistant setting.…”

Management of newly diagnosed metastatic hormone‐sensitive prostate cancer: A survey of UK Uro‐oncologists

“…24 In the survey reported above, reasons for refusing docetaxel included witnessing the detrimental effects on fellow patients. 18 There were different responses with respect to metastatic burden-a strong recommendation in 64% of patients with high-volume disease compared with only 31% of patients with low-volume disease. This reflects the findings from CHAARTED, where overall survival in patients with high-volume disease was superior with docetaxel, but no benefit was observed in patients with low-volume disease.…”

“…It should be remembered that the adverse effects of docetaxel that matter most to patients may not be obvious from clinical trial data; in a real-life survey of men with mHSPC the most troublesome effects associated with docetaxel treatment included fatigue, nausea, vomiting, anaemia, diarrhoea, mouth ulcers, rash and bone pain. 18 Notably, an impact on daily activities was also reported, eg, limits to ambulatory capacity and psychological effects. In an analysis of data from GETUG-AF15, all cumulative toxicity measures (ie, all grades/severity of adverse events) were associated with reduced quality of life.…”