Results from the CHAARTED trial demonstrated that androgen deprivation therapy (ADT) plus docetaxel improves overall survival (OS) and quality of life (QOL) at 12 months when compared with ADT treatment alone for metastatic hormone-sensitive prostate cancer (mHSPC).
Research on the prognostic relationship between QOL, disease characteristics, and OS will be presented at the American Society of Clinical Oncology 2023 Annual Meeting.
A total of 790 patients (ADT plus docetaxel, n=397; ADT, n=393) were included in the CHAARTED trial and were given a Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire to complete to gauge their QOL. Log-rank test and Cox proportional hazards models were used to test the association between QOL and OS by clinical and disease characteristics.
Patients with a baseline higher QOL by FACT-P (n=790) were associated with better OS in univariate regression (hazard ratio [HR], 0.70; 95% CI, 0.55-0.90; P=.005). However, the association was not significant upon multivariate analysis (HR, 0.80; 95% CI, 0.62-1.04; P=.09). A trend toward improved survival in patients with the lowest baseline QOL was seen in those patients treated with ADT plus docetaxel compared with ADT alone (HR, 0.75; 95% CI, 0.53-1.05; P=.09). Patients with the highest baseline QOL had similar survival regardless of treatment arm (HR, 0.92; 95% CI, 0.63-1.36; P=.69).
Higher 3-month QOL measured by FACT-P (n=654) was associated with survival in the multivariate analysis independently of treatment arm (HR, 0.76; 95% CI, 0.58-1.0; P=.05). Patients with the highest 3-month QOL had comparable survival regardless of treatment arm (HR, 1.11; 95% CI, 0.73-1.67; P=.63), and patients with the lowest 3-month QOL experienced a survival benefit with ADT plus docetaxel compared with ADT (HR, 0.69; 95% CI, 0.48-0.99; P=.047).
This analysis shows that 3-month QOL was significantly associated with higher survival rates in patients with mHSPC. Patients with the poorest QOL experienced survival benefit from treatment with ADT plus docetaxel regardless of disease volume. In contrast, patients with the highest QOL did not benefit from ADT plus docetaxel despite the large number of patients with high-volume disease in that cohort. The study’s findings suggest that consideration of QOL may improve decision-making and patient selection when considering chemohormonal treatment for mHSPC.
