1. Use of Docetaxel based Chemotherapy for Castrate Resistant Prostate Cancer at LASUTH Ikeja Lagos Olufunmilade Akin 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/m 2 - 5 patients Weekly dose : 30mg/m 2 - 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

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