For patients with high-risk metastatic castration-sensitive prostate cancer who have completed upfront ADT + docetaxel, would you consider starting abiraterone or enzalutamide in addition to ADT while the disease is still castration-sensitive?
No. In patients with castration-sensitive disease on ADT who have completed six cycles of docetaxel as per the CHAARTED data (Sweeney et al. NEJM 2015), there is no good evidence that adding abiraterone after docetaxel while still castration-sensitive is warranted. Abiraterone has potential harm and...
Presently there is no data to support the practice of potent AR blockade with docetaxel/ADT in men with mHSPC. Ongoing studies will address this, including ENZAMET, ARCHES, and PEACE1, and STAMPEDE is testing the addition of a range of novel therapies to ADT/abiraterone or ADT/docetaxel including me...
Separate studies have investigated the role of upfront docetaxel, and abiraterone plus prednisone in addition to standard androgen deprivation therapy (ADT) in the new hormone sensitive metastatic prostate cancer (mHSPC) setting, and have shown improved survival outcomes with these interventions. Gi...
I don't use abiraterone or other next-generation hormonal therapies (NHTs) immediately following docetaxel in HSPC and acknowledge that enzalutamide did not benefit the subset of patients in ENZAMET with HSPC who received docetaxel. However, I have considered adding a next-generation hormonal therap...
While I completely agree that data are lacking to support ADT+docetaxel+abiraterone in high risk mPC, the question was “ would you consider”. Given benefits of ADT+docetaxel and ADT+abiraterone it is hard (in my view) NOT to “consider“ ADT+docetaxel+abiraterone. No doubt the trial must be done...and...
The possibility is certainly interesting, but I must agree with my esteemed colleague, @Dr. First Last. In the absence of information on safety and efficacy, AND with considering the potential costs of care (both for drug and accompanying supportive care), it would not be appropriate to recommend th...