Dr. Bryce on the Use of Abiraterone Versus Docetaxel in Patients With Prostate Cancer

Alan H. Bryce, MD, assistant professor of medicine, Mayo Clinic, discusses the importance of individualized approaches in the use of abiraterone (Zytiga) versus docetaxel in patients with metastatic hormone-sensitive prostate cancer.

Both abiraterone and docetaxel are approved in the frontline setting for hormone-sensitive metastatic disease. There’s no easy answer as to whether patients should receive abiraterone or docetaxel; it’s very individualized to the patient. It depends on the patient’s disease state, disease burden, pace of disease, and the patient’s tolerability.

Data from the STAMPEDE study suggest that in the frontline setting, there is very little difference between the two agents in terms of overall survival. This was a secondary and underpowered analysis from the trial, so it’s not a definitive answer, says Bryce.

Docetaxel is more toxic in the short-term. Most patients tend to favor abiraterone because it is a milder agent. Researchers are now trying to define the subsets of patients who will do better on chemotherapy than on abiraterone.