Role of Chemotherapy in the Current Treatment Paradigm for Men With CRPC.

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Presentation transcript:

Role of Chemotherapy in the Current Treatment Paradigm for Men With CRPC

CRPC How do you decide who gets chemotherapy these days?

Who Should Get Chemotherapy Who Should Get Chemotherapy? Patients with disease that is rapidly progressing, which may be less sensitive to androgen blockade.

Second-line Chemotherapy Adverse Effects Issues

Chemotherapy Avoiding Undue Toxicity

Chemotherapy Failure of Adding Targeted Agents

Targeted Agents + Chemotherapy Potential Scheduling Problems

Targeted Agents + Chemotherapy Better preclinical data are needed to design the next round of trials!

Retreatment With Chemotherapy It is feasible in a selected group of patients who responded initially.

Manipulating Hormone Therapy Is it possible to safely make the disease more chemo-sensitive?

Radium-223 Where does it fit in relation to chemotherapy?

Ra-223 Before Chemotherapy or in Combination With Other Agents Ra-223 Before Chemotherapy or in Combination With Other Agents? Because Ra-223 does not induce bone marrow toxicity, this possibility needs to be tested in clinical trials.

Should Chemotherapy Be Moved Earlier in the Course of Disease Should Chemotherapy Be Moved Earlier in the Course of Disease? Currently, chemotherapy should not be given outside the metastatic castration-resistant setting!