Key Points
➤ Prostate cancer is the most commonly diagnosed cancer in men,
representing 19% of all newly reported cancer cases.
➤ It is responsible for 8% of all cancer deaths in men.
➤ Patients who have newly diagnosed radiographically evident metastatic
disease, either as a de novo diagnosis of prostate cancer or as a
manifestation of disease progression through earlier clinical disease states,
are termed as having "metastatic non-castrate" prostate cancer.
➤ Historically, standard treatment for metastatic non-castrate disease has
been androgen deprivation therapy (ADT) until progression, at which time
patients are described as having metastatic castration-resistant prostate
cancer (mCRPC), and then ADT is continued with additional treatments
offered.
Treatment
ADT + Docetaxel
➤ For men with metastatic non-castrate prostate cancer with high
volume disease per CHAARTED who are candidates for treatment with
chemotherapy, the addition of docetaxel to ADT should be offered. (Strong
Recommendation for high volume disease patients as per CHAARTED; EB-H)
➤ For patients with low volume disease per CHAARTED who are candidates
for chemotherapy, docetaxel plus ADT may be offered. (Moderate
Recommendation for low volume disease patients; EB-H)
➤ The appropriate regimen of docetaxel is six doses of docetaxel given every
three weeks at 75 mg/m
2
either alone (per CHAARTED) or with prednisolone
(per STAMPEDE). (Strong Recommendation; EB-H)
