What are the NCCN treatment guidelines for metastatic castration-resistant prostate cancer (CRPC) with visceral metastases?

Updated: Jul 31, 2017
  • Author: Bagi RP Jana, MD; more...
  • Print
Answer

Answer

Docetaxel with prednisone (preferred treatment)

Addition of estramustine to docetaxel not recommended

Enzalutamide (category 1)

Abiraterone for men who decline chemotherapy

Second-line treatment for patients with visceral metastases who experience progression of disease after treatment with enzalutamide or abiraterone is as follows:

  • Docetaxel with prednisone

  • Clinical trial

  • Abiraterone, if the patient had previously taken enzalutamide

  • Enzalutamide, if the patient had previously taken abiraterone

  • Other secondary hormone therapy (eg, antiandrogen, antiandrogen withdrawal, ketoconazole, corticosteroids, diethylstilbestrol or other estrogen)

  • Best supportive care

Second-line treatment for patients with visceral metastases who experience progression of disease after treatment with docetaxel is as follows:

  • Enzalutamide

  • Abiraterone with prednisone

  • Cabazitaxel with prednisone

  • Clinical trial

  • Docetaxel rechallenge

  • Alternative chemotherapy (mitoxantrone)

  • Other secondary hormone therapy (eg, antiandrogen, antiandrogen withdrawal, ketoconazole, corticosteroids, diethylstilbestrol or other estrogen)

  • Best supportive care


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!