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Cancer

Chemotherapy Options for Prostate Cancer

Summary & Participants

Traditionally, chemotherapy had almost no role in treating prostate cancer. But today, new chemotherapy drugs have been proven to not only provide symptom relief, but also extend the lives of patients with advanced prostate cancer.

Medically Reviewed On: July 18, 2008

Webcast Transcript

ANNOUNCER: Traditionally, chemotherapy had little to no role in treating advanced prostate cancer.

TOMASZ BEER, MD: Initially, there were many, many studies that looked at chemotherapy agents that really weren’t showing much activity at all in advanced prostate cancer. And in fact when I started working on it, the mantra was that chemotherapy’s not helpful in this cancer.

CELESTIA S. HIGANO, MD: At the end of the ’80s, one of my colleagues wrote a review article about chemotherapy in the setting of prostate cancer, and their conclusion was that there was no benefit for chemotherapy.

ANNOUNCER: Doctors had been using the steroid prednisone to alleviate symptoms associated with advanced prostate cancer, and in the 1990s, a chemotherapy agent was proven effective for decreasing pain.

CELESTIA S. HIGANO, MD In the mid-’90s, we had the study with mitoxantrone and prednisone showing that the combination of the chemotherapy with prednisone was better than prednisone alone for helping patients with symptoms.

TOMASZ BEER, MD: Mitoxantrone in combination with prednisone can have important benefits in terms of pain control and quality of life, without extending life. But in patients who have advanced cancer and have significant symptoms, quality of life benefits were very important.

ANNOUNCER: But before 2004, oncologists couldn’t give patients much hope that chemotherapy could improve survival.

TOMASZ BEER, MD: And then docetaxel came along, which not only improved upon mitoxantrone with regard to pain control, but also provided for the first time a benefit with regard to survival in men who have advanced metastatic prostate cancer and who are no longer responding to hormonal therapy.

ANNOUNCER: Docetaxel, under the brand name Taxotere, has been proven to not only alleviate symptoms of cancer, but it also has shown a survival benefit.

CELESTIA S. HIGANO, MD: In the clinical trials, the median time -- that means half the patients -- lived as long as 18 to 19 months, and half the patients lived less long. And that is a two-month improvement over the median for the other combination, which was mitoxantrone and prednisone.

But I think that when you say there’s a two-month survival advantage, some people are rather shocked at how short that is. But this is for a whole group of men. This is not what the individual may get. And in fact, we’ve had some excellent, good long-term results with patients. I have patients who have had metastatic prostate cancer on and off chemotherapy for over five years.

ANNOUNCER: Currently docetaxel plus prednisone is the FDA-approved regimen for advanced prostate cancer. But researchers are also testing docetaxel with other agents in a number of clinical trials.

CELESTIA S. HIGANO, MD: We’re at the beginning of a big learning experience about what other drugs we can combine with docetaxel to improve on what we’ve seen with docetaxel and prednisone.

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