Cancer Control. 2026 Jan-Dec;33:10732748261481960. doi: 10.1177/10732748261481960. Epub 2026 Aug 23.
ABSTRACT
IntroductionThe optimal choice between docetaxel and abiraterone in combination with androgen deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer (mHSPC) remains uncertain due to the lack of direct randomized trials. Real-world data, particularly from developing countries, are limited. This study aimed to compare the effectiveness of docetaxel versus abiraterone in combination with ADT and to identify prognostic factors associated with survival outcomes in a Vietnamese population.MethodsWe conducted a retrospective cohort study of patients with mHSPC treated at Vietnam National Cancer Hospital between January 2021 and December 2025. Eligible patients received first-line ADT combined with either docetaxel or abiraterone acetate. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox proportional hazards models were applied to evaluate prognostic factors.ResultsBaseline characteristics were generally comparable. Abiraterone was associated with a higher rate of deep prostate-specific antigen (PSA) response at 6 months (PSA≤0.2 ng/mL: 43.7% vs. 16.7%, p=0.002). After a median follow-up of 28.6 months, the median OS was 41.4 months in the docetaxel group and 44.6 months in the abiraterone group. Median PFS was 23.6 and 29.6 months, respectively, with no statistically significant differences between groups. In multivariable analysis, baseline PSA>100 ng/mL (HR 1.98, p=0.01, 95% CI: 1.15-3.42) and PSA>0.2 ng/mL at 6 months (HR 3.93, p<0.001, 95% CI: 1.82-8.49) were independent predictors of worse PFS. PSA>0.2 ng/mL at 6 months was also associated with inferior OS (HR 2.66, p=0.03, 95% CI: 1.09-6.47).ConclusionIn this real-world Vietnamese cohort, docetaxel and abiraterone combined with ADT provided comparable survival outcomes in mHSPC. Although abiraterone achieved deeper PSA responses, this did not translate into a survival advantage. Baseline PSA and 6-month PSA response were strong prognostic factors, underscoring the clinical value of PSA kinetics in risk stratification and treatment monitoring.
PMID:42633534 | DOI:10.1177/10732748261481960
