Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 10, 2015; 6(5): 99-103
Published online Oct 10, 2015. doi: 10.5306/wjco.v6.i5.99
Is there still a place for docetaxel rechallenge in prostate cancer?
Roberto Petrioli, Edoardo Francini, Giandomenico Roviello
Roberto Petrioli, Giandomenico Roviello, Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Edoardo Francini, Medical Oncology Unit, Policlinico Umberto I Hospital, University of Rome, 00161 Rome, Italy
Author contributions: Petrioli R and Roviello G contributed to study design and writing; Edoardo F contributed to writing.
Conflict-of-interest statement: No author has actual or potential conflicts of interest, including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could influence, or be perceived to influence, their work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Petrioli, MD, Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 11, 53100 Siena, Italy. r.petrioli@ao-siena.toscana.it
Telephone: +39-05-77586139 Fax: +39-05-77586231
Received: March 11, 2015
Peer-review started: March 18, 2015
First decision: June 3, 2015
Revised: June 15, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: October 10, 2015
Processing time: 216 Days and 9.9 Hours
Abstract

Three-weekly docetaxel plus prednisone is the standard first-line cytotoxic treatment for patients with metastatic castrate-resistant prostate cancer (mCRPC). Today, several new treatment options are available for patients with tumor progression after first-line docetaxel: Abiraterone, enzalutamide, cabazitaxel, sipuleucel-T immunotherapy, and the radionuclide radium-223. However, despite the evolving scenario in CRPC treatment, the optimal sequencing of the innovative therapies remains unclear. The reintroduction of docetaxel at the occurrence of disease progression after a drug holiday (docetaxel rechallenge) was often proposed, and this chemotherapeutic agent showed to maintain antitumor activity in mCRPC patients. Docetaxel rechallenge may still constitute a valid treatment option mainly for patients with favorable response to first-line docetaxel, at least > 3 mo progression-free interval, age less than 75 years, good performance status, and acceptable docetaxel toxicity. The risk of cumulative toxicity must be evaluated, since sensory neuropathy, nail disorders and fatigue might occur on docetaxel rechallenge.

Keywords: Abiraterone acetate; Docetaxel; Prostate cancer; Prostate-specific antigen; Rechallenge

Core tip: New treatment options are currently available for metastatic castrate-resistant prostate cancer (mCRPC) patients after first-line chemotherapy with docetaxel. The actual role of docetaxel rechallenge in the evolving scenario of mCRPC treatment is discussed in this editorial.