Two different “takes” from the results of the CHAARTED trial

In the October 15 issue of Oncology differing authors provide differing perspectives on the interpretation of the results of the CHAARTED trial reported by Sweeney et al. at the annual meeting of the American Society for Clinical Oncology earlier this year.

Suzman and Antonarakis argue that the correct way to interpret the data from this trial is that all newly diagnosed, androgen deprivation therapy (ADT)-naive men with metastatic prostate cancer should be treated with the combination of ADT + docetaxel chemotherapy, regardless of the volume of metastatic prostate cancer.

By contrast, Armstrong, apparently agreeing with the original study authors, argues that the study shows clearly that — at this time — only men with a significant load of metastatic disease (originally defined as four evident metastatic sites or more) should actually receive ADT + docetaxel (as opposed to ADT alone) because there was no evident survival benefit for men with a low load of metastasis at the time of the most recent data analysis.

It is certainly possible to justify either of these interpretations. Which one is actually “right” is impossible to tell at this time. However, if one takes the “first do no harm” attitude to medical care, it certainly seems that Armstrong would “hold the upper hand” in the moral and ethical argument.

One Response

  1. I think that I would be a good candidate for ADT + docetaxel. I was diagnosed in March 2014 with metastatic prostate cancer. I also had quite a heavy load of metastases (30+).

    At the time I had not heard of docetaxel. However, I had found information for a double-blind trial for my type of case (minimum 4 metastases, Gleason at least 8): ADT + Zytiga + cortisone or ADT + placebo. I fortunately could be referred to and was accepted into that trial. Everything seems to be going fine so far. PSA went from 560 at the beginning of ADT to below 1.0 for the last 4 months.


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