Efficacy vs. effectiveness — docetaxel and prednisone in hormone refractory prostate cancer

Abstract

To assess the clinical effectiveness of docetaxel and prednisone in a clinical setting and to compare the results to those seen in the pivotal clinical trial. To assess the impact of various factors on the prognosis of patients treated with docetaxel. Retrospective chart review. The primary outcome measured was survival. Survival data was analyzed through the Kaplan-Meier methodology. A multivariate analysis of prognostic variables was also conducted. Public cancer centers within the Canadian province of Alberta. Hormone refractory, metastatic prostate cancer patients initiated on docetaxel chemotherapy between September 2004 and February 2007 within the Alberta Cancer Board. Main Outcome Measured. The primary outcome measured was median survival. Among 161 patients eligible for review, median survival was 17.22 months. Chemotherapy received after docetaxel was determined to be a significant favorable prognostic factor for survival (p<0.0001). In a clinical setting, docetaxel and prednisone did not perform as well in terms of median survival, as it was shown to in prior clinical trials (17.22 vs. 18.9 months). Further investigation into the impact of docetaxel and prednisone on quality of life in clinical practice, would complement the findings of this study.