Where Does Chemotherapy Fit into Prostate Cancer Treatment?

Ian D Davis, Carmel J Pezaro

Research output: Contribution to journalArticleOtherpeer-review


The treatment of metastatic castrate-resistant prostate cancer has changed dramatically in recent years. Several agents have been shown to improve survival in men with castrate-resistant prostate cancer after docetaxel and, for abiraterone acetate and enzalutamide, in chemotherapy-naïve castrate-resistant prostate cancer patients also. These two drugs are now approved and reimbursed in Australia for use in castrate-resistant prostate cancer after docetaxel, or in men unsuitable to receive chemotherapy. It is reasonable to hypothesise that use of these novel survival-prolonging therapies earlier in the treatment course might improve outcomes and this hypothesis is currently being tested in clinical trials. Cytotoxic chemotherapy is often seen as a less desirable treatment strategy and perhaps some men with castrate-resistant prostate cancer are no longer being considered for this treatment. This perception might also lead to changes in management and prescribing practices, including a shift away from multidisciplinary decision-making. However, a careful review of the available literature suggests that this strategy might not be in the best long-term interests of these men and that cytotoxic chemotherapy, rather than being
undesirable, might instead be best used as first line management in men able to receive it.
Original languageEnglish
Pages (from-to)195-198
Number of pages4
JournalCancer Forum
Issue number3
Publication statusPublished - 2015

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