Systemic treatment for metastatic prostate cancer Ian Ingledew Consultant Nurse Gloucestershire Oncology Centre
Docetaxel (Taxotere) IV Chemotherapy With daily Prednisolone (TXP) 21 day cycle 6-10 cycles STAMPEDE Trial (May 2015)
Docetaxel (Taxotere) Side effects Hair loss Myelosuppression (risk of neutropenic sepsis) Fatigue Diarrhoea Peripheral sensory neuropathy (Can be long term/permanent)
Enzalutamide (Xtandi) 4 Tablets daily Monthly assessment Homecare Side effects High BP, fatigue, hot flushes, headaches, memory problems, seizures (rare)
Abiraterone (Zytiga) 2 tablets daily With Predisolone (reduces side effects) Monthly assessments Side effects Fluid retention, high BP, diarrhoea, hypokalaemia, abnormal LFTs
Cabazitaxel (Jevtana) IV chemotherapy With daily Prednisolone 21 day cycle Side effects similar to Docetaxel
Radium 223 (Xofigo) For bone metastases IV drug (in Nuclear Medicine) 28 day cycle Up to 6 cycles Drug mimics calcium so readily taken up by bones. Delivers radiation over short distances
Radium 223 (Xofigo) Side effects Increase in pain initially Diarrhoea Myelosuppression (Hb >100g/L)