For the first time, a large randomized trial has suggested that overall survival is improved by the addition of adjuvant chemotherapy to androgen suppression and radiotherapy in men with localized, high-risk, hormone-sensitive prostate cancer. Docetaxel has been used to treat metastatic hormone-resistant prostate cancer for a number of years, and this new study—RTOG 0521—suggests that moving it up earlier in the course of treatment to the adjuvant setting may extend the lives of men with high-risk, hormone-sensitive prostate cancer.1
Results of RTOG 0521 are part of an emerging story, suggesting that docetaxel can be used earlier in the course of disease. Both the CHAARTED2 and STAMPEDE3trials found that docetaxel improved survival in men with high-risk metastatic hormone-sensitive prostate cancer, whereas before these trials, docetaxel was confined to the hormone-resistant metastatic setting.
RTOG 0521 was designed to assess 4-year survival, and the authors believe that with longer follow-up, the overall survival benefits of adjuvant docetaxel in this setting will continue to emerge.
