This is a review article rather than an original research article. But it is timely. The focus is on the three large randomized control trials that have looked at combining short-term chemotherapy with ADT. Before these studies, chemotherapy for prostate cancer was reserved for late stage patients with symptomatic metastases. Because of its toxicity and limited contribution to overall survival, it made sense to save chemo as a treatment of last resort. The new data, though, suggest a survival benefit in combining ADT with docetaxel administrated early to patients with hormone naïve metastatic disease.
Although the median benefit in survival was 17 months, it was also clear that this was not seen in all patients. In the next few years, with growing attention to personalized medicine, we are likely to see genetic screening that will help us decide who will benefit most from the early chemo & ADT combination.
Ceresoli GL, De Vincenzo F, Sauta MG, Bonomi M, Zucali PA. 2015. Role of chemotherapy in combination with hormonal therapy in first-line treatment of metastatic hormone-sensitive prostate cancer. Q J Nucl Med Mol Imaging 59(4):374-380. www.ncbi.nlm.nih.gov/pubmed/26222275