Docetaxel chemotherapy remains the standard of care in castration-resistant prostate cancer

This Practice point commentary discusses the findings of a randomized, multicenter, report published by Berthold et al, in which the results of the pivotal TAX 327 study are updated. The original TAX 327 study, published in 2004, randomly allocated men with castration-resistant prostate cancer to one of three chemotherapy regimens: docetaxel 75 mg/m2 administered every 3 weeks, docetaxel 30 mg/m2 administered weekly for 5 of every 6 weeks, or mitoxantrone 12 mg/m2 every 3 weeks. All patients received prednisone 5 mg twice daily. The original trial showed a significant survival benefit for those patients receiving docetaxel every 3 weeks compared with those receiving mitoxantrone. The updated analysis demonstrates that docetaxel remains the standard first-line chemotherapy for patients with castration-resistant prostate cancer. This commentary highlights the key results that were updated from the original TAX 327 study and also discusses several unresolved issues, including the optimum timing of chemotherapy initiation and its duration.