Dr. Oh on Remaining Challenges With Docetaxel in Prostate Cancer

William K. Oh, MD, chief, Division of Hematology and Medical Oncology, professor of Medicine and Urology, Mount Sinai School of Medicine, discusses the challenges that remain with the use of docetaxel to treat patients with prostate cancer.

The biggest question in the next few years, according to Oh, will involve determining whether using treatments approved for metastatic castration-resistant prostate cancer (mCRPC) earlier will have a more profound impact for patients. He says this remains to be seen for some of the newer approved treatments, such as abiraterone (Zytiga), enzalutamide (Xtandi), or radium-223 (Xofigo). These agents will all be tested in randomized trials over the next few years.

Oh also questions whether oncologists can substitute those treatments for the benefit of chemotherapy with docetaxel, but there simply isn't an answer yet. For now, he explains, docetaxel's survival benefit is one of the most profound that the field of mCRPC has seen in quite some time. While the newer treatments are exciting, he strongly encourages oncologists in this space to refer their patients for early chemotherapy treatment.

Additionally, Oh wants to remind oncologists that, though many of these men are older, they may also be very fit and thus able to tolerate chemotherapy. The choice to administer docetaxel to these patients should depend more on the individual's physiologic age. He also argues that chemotherapy can be given in a situation where the patient's risk of dying of cancer is high enough such that the oncologist can justify the relative survival benefit.