Should docetaxel be administered earlier in prostate cancer therapy?

Abstract

Three randomized studies examining docetaxel early in metastatic prostate cancer were recently reported. The CHAARTED and STAMPEDE studies showed a survival benefit for docetaxel when started with androgen suppression therapy in men with newly diagnosed metastatic prostate cancer. The STAMPEDE study also included men with biochemically relapsed prostate cancer. The benefit was a median of 13.6 months in the CHAARTED study and 10 months in STAMPEDE. The survival benefit in CHAARTED was stronger in those with high volume disease. The benefit in STAMPEDE was greater in metastatic, rather than biochemically relapsed, prostate cancer. The third study, GETUG-AFU 15, was a smaller study without a survival benefit. These data have changed how we treat metastatic prostate cancer at our centers, as we now offer all men with metastatic castration sensitive prostate cancer docetaxel chemotherapy upfront.

Keywords:

• chemotherapy
• docetaxel
• metastatic disease
• overall survival
• prostate cancer

Financial & competing interests disclosure

JN Graff has received research funding from Sanofi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.