For several years, docetaxel was the only treatment shown to improve survival of patients with metastatic castration-resistant prostate cancer (mCRPC).
There are now several novel agents available, although chemotherapy with docetaxel and cabazitaxel continues to play an important role. However, the increasing number of available agents will inevitably affect the timing of chemotherapy and therefore it may be important to offer this approach before declining performance status renders patients ineligible for chemotherapy. Patient selection is also important to optimize treatment benefit. The role of predictive biomarkers has assumed greater importance due to the development of multiple agents and resistance to available agents. In addition, the optimal sequence of treatments remains undefined and requires further study in order to maximize long-term outcomes. We provide an overview of the clinical data supporting the role of chemotherapy in the treatment of mCRPC and the emerging role in metastatic castration-sensitive prostate cancer. We review the key issues in the management of patients including selection of patients for chemotherapy, when to start chemotherapy, and how best to sequence treatments to maximize outcomes. In addition, we briefly summarize the promising new chemotherapeutic agents in development in the context of emerging therapies.
Written by:
Sonpavde G, Wang CG, Galsky MD, Oh WK, Armstrong AJ. Are you the author?
UAB School of Medicine, Birmingham, AL, USA.
Reference: BJU Int. 2014 Jul 21. Epub ahead of print.
doi: 10.1111/bju.12867
PubMed Abstract
PMID: 25046451
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