Sequencing treatment for metastatic prostate cancer

Abstract

In the past 10 years there have been significant advances in the understanding and treatment of metastatic prostate cancer. These include the earlier use of docetaxel chemotherapy, and the use of abiraterone, enzalutamide, radium‐223 and cabazitaxel.1–6 This has led to significant improvements in survival, but has increased the choice and complexity of treatment. In this article, the authors review these advances and look at the sequencing of agents.

Addition of Docetaxel to Androgen Receptor Axis–targeted Therapy and Androgen Deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer: A Network Meta-analysis

“…The early integration of docetaxel has a strong biological and clinical rationale. Preclinical data suggest that early introduction of cytotoxic chemotherapy around the time of initiation of ADT may eliminate de novo castrationresistant clones and thereby induce a more prolonged remission [37][38][39][40]. Furthermore, earlier use of docetaxel as part of a triplet maximizes the therapeutic window; progression after initial treatment with the doublet of ADT plus ARAT may occur rapidly and be accompanied by symptoms, leaving a smaller proportion fit for docetaxel than if it were received earlier in the disease course [38].…”