Early use of chemotherapy in metastatic prostate cancer. (April 2017)

• Record Type: Journal Article
• Authors: Markowski, Mark C.; Carducci, Michael A.
• Is Part Of: Cancer treatment reviews. Volume 55(2017)
• Page Start: 218
• Page End: 224
• Publication Date: 2017-04
• Subjects: Docetaxel -- Hormone sensitive -- Androgen deprivation therapy; Cancer -- Periodicals; Cancer -- Treatment -- Periodicals; Neoplasms -- therapy -- Periodicals; Cancer -- Périodiques; Cancer -- Traitement -- Périodiques; Cancer -- Treatment; Electronic journals; Periodicals; 616.99406
• DOI: 10.1016/j.ctrv.2016.09.017
• Languages: English
• ISSNs: 0305-7372

Abstract

Highlights: The optimal sequence of therapies for metastatic prostate cancer is unknown. Chemotherapy is commonly deferred in castration resistant prostate cancer. Recent data favors early use of chemotherapy in hormone sensitive disease. Abstract: Since 2010, five new antineoplastic therapies have been FDA approved for the treatment of metastatic prostate cancer. With additional treatment options, questions arose about the optimal sequence of these agents. Until recently, chemotherapy has been deferred until later in the disease course in favor of next-generation androgen deprivation therapy. Prior to the development of abiraterone acetate and enzalutamide, clinical trials were opened investigating the combination of chemotherapy with androgen deprivation therapy in patients with metastatic hormone-sensitive disease. With the development of new oral therapies used to treat castration-resistant disease, these trials were largely forgotten or felt to be obsolete. Recently, two trials have been reported showing an overall survival benefit of the early use of chemotherapy in patients with hormone-naive prostate cancer, changing the treatment paradigm for metastatic disease. Here we review the history of chemotherapy in treating prostate cancer and the emerging evidence favoring its use as first-line therapy against metastatic hormone-sensitive disease.