Prostate Cancer Chemotherapy in the Era of Targeted Therapy

A. Michael; K. Syrigos; H. Pandha

Disclosures

Prostate Cancer Prostatic Dis. 2009;12(1):13-16. 

In This Article

Adjuvant Chemotherapy

Adjuvant chemotherapy is the standard of care after radical surgery in most common epithelial cancers such as breast, bowel, lung and ovarian cancer, where it offers a survival advantage but is still associated with acceptable toxicity. The difference in the prostate cancer context has been the lack of efficacy of a large number of chemotherapies in the metastatic setting, unlike in breast and gastrointestinal cancers. At the same time, patients at 'high risk' with presumed micrometastatic disease may be easily identified and targeted for new studies. Previously, the National Prostate Cancer Project compared cyclophosphamide or estramustine with observation after radical prostatectomy or radiotherapy and found that the estramustine-treated group had a significantly longer PFS than the other groups.[7] Adjuvant weekly taxotere in patients with high-risk prostate cancer after radical prostatectomy[8] has been reported recently. At a median follow-up of 28 months (range 10.5-38.5), the median PFS of 15.7 months was longer than the predicted 10-month median PFS for a matched population. Two large randomized phase III studies are currently under way: the SWOG 9921 trial compares mitoxantrone/prednisolone in addition to 2 years of hormone treatment versus hormone treatment alone (www.swog.org). The TAX 3501 study compares taxotere in a four-arm study with immediate versus delayed hormone deprivation therapy.

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