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Olufunmilade Akin Omisanjo

Use of Docetaxel based Chemotherapy for Castrate Resistant Prostate Cancer at LASUTH Ikeja Lagos. Olufunmilade Akin Omisanjo. B ackground. Burden of CAP No widespread screening in Nigeria Late presentation Inevitable progression to CRPC. Background II. Challenges with CRPC in Nigeria

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Olufunmilade Akin Omisanjo

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  1. Use of Docetaxel based Chemotherapy for Castrate Resistant Prostate Cancer at LASUTH Ikeja Lagos OlufunmiladeAkin Omisanjo

  2. Background • Burden of CAP • No widespread screening in Nigeria • Late presentation • Inevitable progression to CRPC

  3. Background II • Challenges with CRPC in Nigeria -different criteria - available treatment options - costs - “physician apathy “ • Dearth of Medical/Radiation Oncologists • Limited documented experience

  4. Objectives • To describe our initial experience with the use of Docetaxel based Chemotherapy in the treatment of CRPC

  5. Materials and Method • Patients with CRPC - Steady rise in PSA - Post Ochidectomy - Antiandrogen Treatment - Antiandrogen Withdrawal & Substitution - Testosterone levels in 5 patients - Karnofsky Index • 15 month period ( Jan 2013 – March 2014 )

  6. Results • 8 patients • Mean age : 70.4years ( 65 – 76yrs) • Mean PSA pre-commencement of Chemotherapy : 553.1ng/ml ( 20 - 1540 )

  7. Results II • 3 weekly dose : 75mg/m2 - 5 patients • Weekly dose : 30mg/m2 - 3 patients • Preparation - FBC - E&U,Cr - LFTs - ECG

  8. Results III • Drug administration by urologists in all cases • 7 patients completed chemotherapy - 5 patients : 6 courses - 2 patients : 10 courses • Discontinued in 1 patient

  9. Results III • Mean drop in PSA : 67.9% • Mean follow up period : 10months ( 4-18mths)

  10. Results IV • Clinical Improvement - analgesia requirements - paraplegia • Mortality - 1 cancer related death - 1 non-cancer related death • 6 alive - 4 patients up to 12months

  11. Discussion • Very high PSA • Acceptable Tolerability - Good performance • ? Cost effectiveness • Study : not about efficacy

  12. Limitations/Recommendations • Limited patients • Need for multi-centre involvement • Chemotherapy for CRPC is possible even in a very busy urology practice • More involvement by urologists

  13. THANK YOU

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