When the TAX327 trial showed that docetaxel offered a survival benefit over mitoxantrone for men with metastatic castration-resistant prostate cancer (mCRPC),1 the news was greeted with a degree of skepticism by some specialists. At that time, prostate cancer was conventionally managed by urology teams, and chemotherapy was considered to have no role outside of symptomatic palliation. However, TAX327 marked a change in the management of mCRPC. Docetaxel has since become, and still remains, the standard of care for men with mCRPC.2 Multidisciplinary teams, including medical oncologists, urologists, and radiation oncologists, play essential roles in the treatment pathway. Within a decade of the landmark docetaxel trial, the prostate cancer community has seen the emergence of exciting data on a variety of treatments that have further extended survival for men with mCRPC, offering the prospect of a continuum of care for those with the condition. Some of these agents remain at the research stage. Two (cabazitaxel3 and abiraterone4) are already accessible to patients in Canada. Like docetaxel, cabazitaxel is a chemotherapeutic agent of the taxane class, while abiraterone is a novel hormonal treatment.
In this supplement, clinicians consider the evidence base for both of these new treatments,5,6 and for treatments that may emerge into the mCRPC landscape in the near future.6 There is discussion of how cabazitaxel and abiraterone, with their differing modes of action and side effect profiles, may play a role in the management of mCRPC to optimize the overall outcome for patients.6 The final article7 discusses how the predictable cytotoxic side effects of cabazitaxel can be minimized and managed, enabling men with mCRPC who have already received docetaxel to have access to second-line chemotherapy as part of their treatment. The authors also provide real-life case studies to illustrate how cabazitaxel is being used in the Canadian clinical setting.
I hope you find the articles interesting and informative.
Footnotes
Competing interests: Dr. Saad has served as a consultant and has been involved in research with Amgen, Astellas, Janssen, Novartis and Sanofi.
This paper has been peer-reviewed.
References
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