In patients who initially received chemo-hormonal first-line therapy for metastatic prostate cancer followed by abiraterone/enzalutamide for castration-resistant disease, would you re-challenge with docetaxel?
Or would you proceed with cabazitaxel or other therapy? Initial chemo-hormonal therapy was ADT + Docetaxel x6 cycles.
Docetaxel rechallenge at time of mCRPC was done in the CHAARTED study, but I think results on the subsequent response are not available. The NCCN Guidelines state docetaxel rechallenge may be considered in the CRPC setting, but retrospective analyses from GETUG-AFU 15 showed limited response to docetaxel rechallenge.
Answer from: Medical Oncologist at Academic Institution
As we all know, very few things regarding therapeutic sequencing in prostate cancer are straightforward. Retreatment with docetaxel was used relatively commonly in the past in patients with mcrpc, especially in those with good initial responses primarily for want of other agents. In this setting, re...
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Answer from: Medical Oncologist at Academic Institution
The median duration of response for docetaxel in the mCRPC setting is relatively short (e.g. median PFS 5.3 months in FIRSTANA; Oudard et al., PMID 28753384) but can be longer than that expected from the treatment duration of docetaxel in the mHSPC setting (e.g. median PFS 9.1 months in docetaxel/pl...