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Annals of Oncology Advance Access originally published online on May 16, 2008
Annals of Oncology 2008 19(10):1749-1753; doi:10.1093/annonc/mdn288
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

urogenital tumors

Survival and PSA response of patients in the TAX 327 study who crossed over to receive docetaxel after mitoxantrone or vice versa

D. R. Berthold1, G. R. Pond2, R. de Wit3, M. Eisenberger4, I. F. Tannock1,* On behalf of the TAX 327 investigators

1 Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
2 Department of Biostatistics, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
3 Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
4 Department of Oncology, Sydney Kimmel Comprehensive Cancer Centre, Johns Hopkins University, Baltimore, MD, USA

* Correspondence to: Dr I. F. Tannock, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada. Tel: +1-416-946-2245; Fax: +1-416-946-4563; E-mail: ian.tannock{at}uhn.on.ca

Background: The TAX 327 study compared 3-weekly docetaxel, weekly docetaxel or 3-weekly mitoxantrone, each with prednisone, for 1006 patients with metastatic hormone-refractory prostate cancer. Survival and symptom control were superior following 3-weekly docetaxel as compared with mitoxantrone. At progression, many patients were treated with the other drug. Here, we provide a retrospective report of survival and prostate-specific antigen (PSA) response after second-line therapy.

Methods: The TAX 327 database provided information about treatment after progression on first-line therapy, and survival has been updated. Investigators were asked to provide information about crossover treatment and serial PSA values.

Results: We identified 232 crossover patients. Median survival after crossover was 10 months and did not depend on direction of crossover. Data on PSA response are available for 96 patients: PSA response (≥50% reduction) occurred in 15% of 71 men receiving mitoxantrone after docetaxel and in 28% of 25 men receiving docetaxel after mitoxantrone. Median PSA progression-free survival was 3.4 months for mitoxantrone after docetaxel and 5.9 months for docetaxel after mitoxantrone.

Conclusions: One quarter of men received crossover therapy and survival was similar in the crossover groups. The PSA response rate to docetaxel after mitoxantrone was higher than that for mitoxantrone after docetaxel.

Key words: docetaxel, hormone-refractory prostate cancer, mitoxantrone, second-line chemotherapy

Received for publication December 30, 2007. Revision received April 2, 2008. Accepted for publication April 14, 2008.


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