Dr. Sweeney on Chemotherapy in Prostate Cancer

Christopher Sweeney, MBBS, medical oncologist, Dana-Farber Cancer Institute, discusses when to give docetaxel as a treatment option for patients with prostate cancer.

Docetaxel is cheaper than other therapies, explains Sweeney. When the patient is healthiest, that is when they are able to receive docetaxel. The patient is done with the therapy after 6-cycles and then they get put on hormonal therapy. Therefore, they are not at risk of the longer toxicities of abiraterone acetate (Zytiga).

The recent positive findings seen with docetaxel come from 2 randomized trials—CHAARTED and STAMPEDE. In the larger STAMPEDE trial (2962 patients), adding docetaxel to standard hormonal therapy significantly improved survival among men with newly diagnosed, hormone-naïve advanced prostate cancer.

The median overall survival (OS) was 81 months with docetaxel plus standard of care (hormonal therapy with or without radiotherapy) versus 71 months with standard of care alone (0.78; 95% CI, 0.66-0·93; P= .006). In the CHAARTED study (790 patients), the median OS was 57.6 months with the combination of docetaxel and androgen-deprivation therapy (ADT) versus 44 months with ADT alone (HR, 0.61; 95% CI, 0.47-0.80; P <.001).