Toxicity with the addition of docetaxel was manageable. Zoledronic acid did not improve either outcome relative to hormone therapy alone, and adding both zoledronic acid and docetaxel netted similar results to those seen with docetaxel alone.
Several other therapies, including next-generation hormone therapies and chemotherapy agents, also are showing promise in prostate cancer, and the optimal timing and sequencing of agents is unknown. STAMPEDE is the first to look at docetaxel and these hormone therapies at the time of diagnosis of advanced disease, he noted.
At present, the data support giving docetaxel before either abiraterone or enzalutamide in this treatment setting, as the drug’s survival advantage persisted even though patients often went on to receive those hormone therapies; however, that strategy might change with future results from this and other trials. “To be honest, it would be a nice position to be in if we had two treatments that improved overall survival upfront. That just gives us a choice. It would be good news obviously,” he concluded.
Dr. James disclosed that he has a consulting, advisory, or speakers’ bureau role with or receives honoraria or research funding (institutional) from Sanofi, Bayer, Merck, Astellas, Janssen, Pierre Fabre, Ferring, OncoGenex, and Pfizer.