STAMPEDE: Better QoL with abiraterone than docetaxel in prostate cancer
medwireNews: Abiraterone is associated with improved quality of life (QoL) relative to docetaxel in men with hormone-naïve prostate cancer, shows an analysis of contemporaneously randomized participants of the STAMPEDE trial.
Researcher Hannah Rush (University College London, UK), who presented the data at the 2020 Genitourinary Cancers Symposium in San Francisco, California, USA, explained that the addition of either abiraterone or docetaxel to the standard of care (SOC) has been shown to improve overall survival in the trial, with no evidence of better survival with one agent over the other.
Therefore, QoL data may help inform treatment options, she added, with the current analysis the “only direct comparison of QoL in men randomized between the two treatments.”
STAMPEDE is a multi-arm, multi-stage trial investigating various therapeutic strategies for the management of locally advanced or metastatic hormone-naïve prostate cancer, explained Rush.
For the current analysis, the researchers evaluated QoL – using the patient-reported EORTC QLQ-C30 and QLQ-PR25 questionnaires – for 342 participants who received abiraterone plus SOC and 173 who received docetaxel plus SOC between November 2011 and March 2013.
The baseline global QoL score was comparable between the abiraterone and docetaxel groups, at a median of 78.0 and 77.8 points, respectively, as was the proportion of men reporting prostate cancer pain, at 16% and 19%, respectively.
But during 2 years of follow-up, global QoL scores were “superior” among abiraterone- versus docetaxel-treated patients, with a significant between-group difference favoring abiraterone of 3.9 points, “which was just below the level we set to indicate a clinically meaningful difference,” commented Rush.
She highlighted that the difference was greatest in the first year, and added: “Although docetaxel treatment will finish by 18 weeks in most patients, scores did not converge until nearly a year after starting treatment.”
And despite less ongoing treatment in the second year, global QoL scores for men who received docetaxel never exceeded those for abiraterone-treated patients, noted Rush.
In accordance with these findings, abiraterone was associated with lower fatigue and pain scores during the 2 years than docetaxel, with significant between-group differences of 3.9 and 6.3 points, respectively.
Rush commented that “although this was an opportune comparison, it provides a unique dataset looking at patients randomized contemporaneously between abiraterone and docetaxel.”
And she concluded: “We suggest the results of this quality of life analysis should be taken into consideration when discussing upfront treatment options for patients.”
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