“Maximizing survival” for men with mCRPC after docetaxel failure


For the patient with metastatic, castration-resistant prostate cancer (CRPC) there is an interesting new article (reprinted from the journal Expert Review of Anticancer Therapy) on the Medscape web site.

Dr. Alison Birtle, the author, is a clinical oncologist based at Rosemere Cancer Centre, Preston, Lancashire in the UK with extensive experience in the care of men with mCRPC. She is not an “academic” physician.

The full text article (“Maximizing survival in metastatic castrate-resistant prostate cancer: a clinical viewpoint“) reviews her experience in treating men who have progressive disease after first-line chemotherapy with docetaxel. While it was clearly drafted before the approval of enzalutamide (Xtandi) and the second approval of abiraterone acetate (Zytiga) — for chemotherapy-naive patients with mCRPC — here in the USA, it still provides a valuable perspective on the use of drugs like cabazitaxel and others in patients who have already failed initial, docetaxel-based chemotherapy.

Based on her personal experience, Dr. Birtle concludes her article on a distinctly positive note:

Prostate cancer treatment has radically changed over the past 5 years, and the landscape is likely to be very different in a further 5-years time. …

With several additional agents that improve prognosis likely to be available in 5 years time, mCRPC will become a chronic illness rather than a terminal diagnosis. The aim, therefore, will be to maintain quality of life and enable men to achieve their own personal goals whilst also improving their overall prognosis.

For readers who are not familiar with the Medscape web site, you do need to register to be able to review material on this site, but you do have the ability to significantly limit the amount of “spam” you receive from the service, and there is no charge to access the content.

5 Responses

  1. From her lips to God’s ear. Her fingers to God’s eyes, perhaps.

  2. That seems to me to be quite an ambitious projection on her part regarding sequencing and how it may work. She may correct. In my personal experience with prostate cancer I have heard these types of projections of just wait 5 years. … Also, as we know, all prostate cancers are not all the same, so a one size fits all conclusion feels like a bit of an overstatement. By the way, the quality of life of the patient she used as an example was not so great — at least from my perspective.

    But progress is progress and that is good. I know as I am “living the dream.”

  3. Bill:

    Look at it this way, at least you aren’t living in Senegal (see article just posted)!

  4. It seems potentially critical — to me, at least — whether, as this oncologist claims, cabizitaxel may preceed abiraterone but not vice versa, or otherwise. Are such opinions now credible or not?

  5. Dear Grover:

    I don’t think we have a clue, as yet, from really reliable data, what the optimal order or orders are of all the new drugs (already available and coming down the pike). It makes no logical sense to me that one would want to reserve a drug like abiraterone to use only after failure of carbazitaxel, but without appropriate “sequencing” trials we will never know.

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