Interesting phase III trial reported in Lancet this week: the study population was of patient with castrate resistant, metastatic prostate cancer, progressing after docetaxel. They were randomized to mitoxantrone vs. a novel taxane cabazitaxel. Toxicity was higher with cabazitaxel, but there was an improvement in both progression free and overall survival. As rad oncs are occaisionally the primary oncologists that prostate cancer patients see, this is a signficant advance worthy of our notice.
[Articles] Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial: "Prostate cancer is the second most common cause of cancer death in men in the USA and the third most common cause of death in developed countries. For patients with metastatic prostate cancer, androgen deprivation therapy improves symptoms, but patients invariably develop progressive disease. On the basis of an improvement in survival compared with mitoxantrone plus prednisone in patients with metastatic castration-resistant prostate cancer, docetaxel in combination with prednisone is standard first-line chemotherapy in this setting. No treatment has been approved by the US Food and Drug Administration, however, for patients whose disease progresses after docetaxel treatment. Mitoxantrone is often administered because of its favourable effects on quality-of-life outcomes. However, no intervention improves survival in this disease setting."