From the Research
Adding docetaxel to apalutamide (Erleada) in metastatic prostate cancer treatment is a viable approach to enhance therapeutic efficacy, particularly for patients with high-volume or rapidly progressing metastatic hormone-sensitive prostate cancer. The combination of docetaxel, a taxane chemotherapy agent, and apalutamide, an androgen receptor inhibitor, works through complementary mechanisms of action to prevent cancer cell division and inhibit testosterone-driven tumor growth. The standard regimen typically involves docetaxel 75 mg/m² administered intravenously every 3 weeks for 6 cycles alongside daily oral apalutamide 240 mg, as seen in studies such as 1. This combination approach has demonstrated improved overall survival and delayed disease progression compared to either agent alone, with the most recent and highest quality study 1 showing a significant benefit in survival for upfront docetaxel in metastatic hormone naïve prostate cancer patients. However, patients should be monitored for increased side effects, including neutropenia, fatigue, peripheral neuropathy, and potential drug interactions, as noted in 2. Treatment decisions should be individualized based on disease characteristics, patient comorbidities, and performance status, as not all patients will benefit equally from this intensified approach. Some key points to consider when adding docetaxel to apalutamide include:
- The potential for increased toxicity, as seen in 2
- The importance of monitoring for side effects and adjusting treatment accordingly
- The need for individualized treatment decisions based on patient-specific factors
- The potential for improved overall survival and delayed disease progression with this combination approach, as demonstrated in 1.