Chemotherapy

Taxane Chemotherapy

Taxane chemotherapy, given with prednisone, is a standard of care option for patients with metastatic castration-resistant prostate cancer (mCRPC). Taxane chemotherapy agents approved for the treatment of advanced prostate cancer include docetaxel (Taxotere®) and cabazitaxel (Jevtana®). These medicines work by killing rapidly-dividing prostate cancer cells by disrupting the protein structures required for cells to function and divide.

Many patients who are suffering from their cancer will see their symptoms (such as pain) improve after starting chemotherapy. For patients with cancer-related symptoms, quality of life is generally better for patients who receive chemotherapy as compared with no therapy.

Docetaxel is also used in the treatment of metastatic hormone-sensitive prostate cancer (mHSPC). In 2015, a large, randomized clinical trial known as CHAARTED showed that men with mHSPC who began ADT plus chemotherapy (docetaxel) lived significantly longer than men who started treatment with ADT alone. Patients with a high burden of metastatic disease and metastases at initial presentation experienced greater benefit with addition of docetaxel.  
 
Today, docetaxel may be added to hormone therapy plus an androgen receptor pathway inhibitor (ARPI) medicine as part of a “triplet” regimen for mHSPC. Ask your doctor if this approach might be right for you. 

Platinum Chemotherapy

Platinum-based chemotherapy agents such as carboplatin (Paraplatin®) are used for the treatment of various cancer types. Platinum chemotherapy is not yet FDA approved for the treatment of prostate cancer; however, it is sometimes used (alone or in combination with other chemotherapies) to treat patients with very advanced prostate cancer who have exhausted all other treatment options, or in patients who have certain genetic subtypes of prostate cancer (e.g., small cell prostate cancer, neuroendocrine prostate cancer).

Chemotherapy has some serious side effects to be aware of, including low white blood cell counts that increase the risk for severe infections. If you have symptoms such as fever and/or inability to keep food/drink down, get medical attention right away. Fatigue and numbness/weakness in your toes or fingers (called neuropathy) are also common. If you experience neuropathy, talk to your doctor so you can make a plan for how to best handle further cycles.

Regardless of the type of chemotherapy you are receiving, you will be monitored very closely by doctors, nurses, and pharmacists to make sure that all side effects are being addressed. Early management of side effects has been shown to help patients live longer, better lives. Communicate with your oncology team as soon as you experience any side effect of treatment.

Last Reviewed: 3/2025