Adjuvant chemo for prostate cancer – pro
There is no evidence to support adjuvant chemotherapy for prostate cancer after curative radiation. Results of several studies are being awaited. Recently completed randomized trials indicate a benefit from the use of hormonal therapy in patients with locally advanced prostate cancer treated with radiation therapy or node positive patients, post radical prostatectomy. While hormone-based combined modality trials have consistently shown improvements in local and systemic disease control, only two of these demonstrated improvements in overall survival. The palliative benefit of chemotherapy in hormone refractory disease and the promising response rates with newer agents has evoked interest in the use of chemotherapy in high-risk prostate cancer in the adjuvant and neoadjuvant settings. Reported trials involving adjuvant chemotherapy in prostate cancer are few, and generally involve small numbers of patients. Some of the studies confirm that certain populations of patients, such as those with node-positive disease, may benefit from systemic therapy. Definitive data, however, will be derived from ongoing randomized trials investigating adjuvant chemotherapy.
At current time the adjuvant chemotherapy that is being delivered is investigational.
Kent EC, Hussain MH.
The rationale for adjuvant chemotherapy for high-risk prostate cancer. Curr Opin Urol. 2003 Mar;13(2):123-31.
Vaishampayan U, Hussain M.The evolving role of systemic therapy in high risk prostate cancer: strategies for cure in the 21st century. Crit Rev Oncol Hematol. 2002 May;42(2):179-88.
Maria Schubert et al,The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multi-institutional Analysis, Advances in Urology Volume 2012 (2012), Article ID 612707, 6 pages NCCN, Prostate Cancer 2017