title: Is there still a place for docetaxel rechallenge in prostate cancer?
abstract: Three-weekly docetaxel plus prednisone is the standard first-line cytotoxic treatment for patients with metastatic castrate-resistant prostate cancer (mCRPC). Today, several new treatment options are available for patients with tumor progression after first-line docetaxel: Abiraterone, enzalutamide, cabazitaxel, sipuleucel-T immunotherapy, and the radionuclide radium-223. However, despite the evolving scenario in CRPC treatment, the optimal sequencing of the innovative therapies remains unclear. The reintroduction of docetaxel at the occurrence of disease progression after a drug holiday (docetaxel rechallenge) was often proposed, and this chemotherapeutic agent showed to maintain antitumor activity in mCRPC patients. Docetaxel rechallenge may still constitute a valid treatment option mainly for patients with favorable response to first-line docetaxel, at least > 3 mo progression-free interval, age less than 75 years, good performance status, and acceptable docetaxel toxicity. The risk of cumulative toxicity must be evaluated, since sensory neuropathy, nail disorders and fatigue might occur on docetaxel rechallenge.
authors.affiliation: Roberto Petrioli, Giandomenico Roviello, Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Petrioli
authors.affiliation: Roberto Petrioli, Giandomenico Roviello, Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Francini
authors.affiliation: Roberto Petrioli, Giandomenico Roviello, Medical Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
keywords: Abiraterone acetate; Docetaxel; Prostate cancer; Prostate-specific antigen; Rechallenge