Although docetaxel is still considered a mainstay of treatment in metastatic castrate-resistant prostate cancer (mCRPC), in the last few years, new agents have been developed to improve survival in this setting and reach a possible optimal personalized treatment strategy.
In this paper, we provide a personal view and an algorithm for mCRPC patients, according to available evidence, personal opinion and experience. Abiratone acetate, cabazitaxel, radium-223, sipuleucel-T and enzalutamide, together with docetaxel, have demonstrated a survival benefit in these patients. The use of rechallenge with docetaxel in mCRPC patients with disease progression after a first response has been considered. These new agents complicated the scenario and posed the challenge to move from the old sequential to a new algorithm-based approach. At this stage, the algorithm is necessarily based on experts' opinion, since the efficacy of a single agent in a specific setting has not been validated by sequential trials.
Written by:
Bracarda S, Sisani M, Marrocolo F, Hamzaj A, Del Buono S, Altavilla A. Are you the author?
Department of Oncology, U.O.C. of Medical Oncology, USL-8, Istituto Toscano Tumori (ITT), Ospedale San Donato, Arezzo, Italy.
Reference: Expert Rev Anticancer Ther. 2014 Nov;14(11):1283-94.
doi: 10.1586/14737140.2014.965686
PubMed Abstract
PMID: 25353258