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Abstract
Introduction. Recent years have witnessed substantial progress in developing novel systemic treatments for metastatic prostate cancer (mPC). This review synthesizes findings from pivotal studies on docetaxel (D) drug therapy in mPC, including analyses of the effects of clinically approved drugs. This review focuses on "gray" understudied aspects of docetaxel application in prostate cancer management, incorporating new data.
Materials and Methods. We analyzed domestic and international publications on docetaxel's role in triple-agent chemotherapy regimens for mPC (including textbooks, research articles, clinical studies, and systematic meta-analyses) published between 2015 and 2024. To fully elucidate the pathophysiological rationale underlying this therapeutic approach, we also incorporated clinical trials and meta-analyses evaluating two-component therapy regimes.
Results. Early administration of docetaxel demonstrates clinical benefits in delaying castration-resistant progression and improving overall survival rates in patients with advanced metastatic disease. While the addition of androgen axis (AA)-targeted therapy to standard treatment (ADT + docetaxel) regimens enhances survival outcomes, the efficacy of docetaxel in AA-refractory cases remains insufficiently investigated. The therapeutic potential of triplet regimens continues to be debated, primarily due to concerns regarding docetaxel's anticipated toxicity profile.
Conclusion. While docetaxel has demonstrated clear benefits as a component of combination therapy for mPCa, several critical questions regarding its precise pathogenetic mechanisms and optimal timing in treatment protocols remain unanswered and require thorough investigation.
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