Continuing enzalutamide with docetaxel in castration-resistant prostate cancer

[...]although biochemical progression alone was a trigger to start docetaxel chemotherapy during androgen receptor pathway inhibitor treatment in the PRESIDE trial, most experts do not usually change the treatment based on biochemical progression alone.10 Second, although a statistically significant increase in progression-free survival was observed with enzalutamide plus docetaxel, this benefit could be negated by the increase in toxic effects and financial burden of continuing enzalutamide. [...]other survival benefits need to be shown. The CHEIRON1 and ACIS2 trials recorded improved radiographic progression-free survival, but improved overall survival was not shown. [...]combination therapy has not become a standard regimen. [...]intensification treatment using androgen receptor pathway inhibitors with or without docetaxel has become a standard therapy in metastatic castration-sensitive prostate cancer and, therefore, the clinical circumstances of the PRESIDE trial will gradually become uncommon.5,6,10 Accordingly, further investigations of the survival benefit of androgen receptor pathway inhibitors for metastatic castration-sensitive prostate cancer would be important before the implementation of androgen receptor pathway inhibition continuation during docetaxel chemotherapy for mCRPC.