In prostate cancer, cytotoxic chemotherapy is reserved for the management of patients with castration-resistant, metastatic disease.1 In this setting, mitoxantrone plus prednisone palliates symptoms in around one in three men.2 More recently docetaxel (75mg/m2, given every 3 weeks, in combination with prednisone) has been shown to prolong survival when used as cytotoxic therapy in CRPC where patients ideally should be counselled, managed and treated in a multi-disciplinary team. Both are recommended as a treatment option by the European Association of Urology.1,3 However, side effects include neutropenia, diarrhoea, fatigue and alopecia and must be discussed with patients alongside the potential benefits before initiating therapy.1,3
References:
1. European Association of Urology. Guidelines on prostate cancer, 2010.
2. Tannock IF, Osoba D, Stockler MR, et al. Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points. J Clin Oncol 1996;14:1756-64.
3. Tannock IF, de Wit R, Berry WR, et al; TAX 327 Investigators. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351:1502-12.