Christopher Sweeney, MBBS

Christopher Sweeney, MBBS, professor of medicine, Harvard Medical School, and physician, Dana-Farber Cancer Institute, discusses the treatment-related adverse events (TRAEs) associated with adding enzalutamide (Xtandi) or non-steroidal anti-androgens to testosterone suppression treatment and docetaxel in patients with metastatic hormone-sensitive prostate cancer, as seen in the ENZAMET (ANZUP 1304) trial (NCT02446405).

Patients in the study were randomized 1:1 to receive either testosterone suppression plus enzalutamide or the non-steroidal anti-androgens, bicalutamide (Casodex), nilutamide (Nilandron), or flutamide (Eulexin). The phase III study results show that TRAEs occurred more frequently in the patients who received enzalutamide versus the non-steroidal anti-androgen, said Sweeney.

All TRAEs were between grades 1 and 3, with fatigue being the most common. Patients also experienced hypertension, syncope, seizures, and falls. Investigators noticed that adding enzalutamide to docetaxel also increased the rate of adverse events often seen with docetaxel alone. These AEs included neutropenic fever, sensory neuropathy, eye tearing, and nail discoloration. Sweeney says that it&rsquo;s important to counsel patients about the possibility of increased docetaxel-related symptoms when adding enzalutamide to their treatment.

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Christopher Sweeney, MBBS, professor of medicine, Harvard Medical School, and physician, Dana-Farber Cancer Institute, discusses the treatment-related adverse events associated with adding enzalutamide or non-steroidal anti-androgens to testosterone suppression treatment and docetaxel in patients with metastatic hormone-sensitive prostate cancer, as seen in the ENZAMET trial.<br />
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Expert Discusses Safety Profile from the ENZAMET Trial

Christopher Sweeney, MBBS, medical oncologist, Dana-Farber Cancer Institute, discusses the optimal use of cabazitaxel for the treatment of prostate cancer.

More oncologists are becoming comfortable with using the cytotoxic chemotherapy cabazitaxel. It is only approved for use after docetaxel.

After prescribing docetaxel to a patient with hormone-sensitive disease, a physician can then choose to administer docetaxel again or switch to cabazitaxel.

Sequencing of abiraterone, enzalutamide, cabazitaxel, docetaxel, sipuleucel-T, and radium-223 is not entirely clear.

The Optimal Use of Cabazitaxel for Prostate Cancer

Christopher Sweeney, MBBS, medical oncologist, Dana-Farber Cancer Institute, discusses the evolving role of chemotherapy for hormone-sensitive prostate cancer.

Oncologists have been trained in the use of chemotherapy â€” they are aware of the side effects.

The side effect profile of chemotherapy is essentially the same as when used for castration-resistant disease.

The question remains: Is there a difference in using docetaxel in the hormone-sensitive or castration-resistant settings?

The rate of neutropenic fever was slightly higher in the CHAARTED study (8%) compared with the TAX 327 study (3%).

Christopher Sweeney, MBBS | Authors

Articles

Expert Discusses Safety Profile from the ENZAMET Trial

The Optimal Use of Cabazitaxel for Prostate Cancer

The Evolving Role of Chemotherapy for Hormone-Sensitive Prostate Cancer