Daniel P. Petrylak, MD, Professor of Medicine, Program Director, Genitourinary Oncology Section, Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, discusses the research and concerns surrounding cytotoxic agents for the treatment of castration-resistant prostate cancer (CRPC).

Numerous phase III trials looking at the combination of docetaxel with novel therapies, bone targeted agents, or angiogenesis inhibitors have all failed to demonstrate a survival benefit when compared to docetaxel alone. Petrylak believes that research may not be looking at the correct targets or the possibilities have been exhausted for initial cytotoxic therapy.

The taxane cabazitaxel is currently in randomized trials that compare it to docetaxel in the first-line setting. This agent is currently approved for the second-line in advanced CRPC, following progression on docetaxel. Discovering the best patients for either docetaxel or cabazitaxel is an important area of research, especially when considering newly approved hormonal therapies and possible combinations.

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