A 68-year-old man with locally advanced prostate cancer (T3bN1M0, Gleason 9) is initiated on androgen deprivation therapy (ADT). The STAMPEDE trial informed combined treatment. What did the addition of docetaxel to ADT demonstrate in this trial?

• A Docetaxel improved overall survival only in metastatic prostate cancer, not non-metastatic locally advanced disease
• B Docetaxel was inferior to abiraterone when added to ADT
• C Docetaxel added to ADT improved PSA response but had no survival benefit
• D Docetaxel combined with ADT improved overall survival in high-volume metastatic and high-risk locally advanced prostate cancer ✓

Explanation

The STAMPEDE trial demonstrated that adding docetaxel to long-term ADT improved overall survival in men with high-risk locally advanced and metastatic prostate cancer starting long-term hormone therapy. Similarly, the CHAARTED trial confirmed docetaxel benefit in high-volume metastatic disease. STAMPEDE also demonstrated survival benefits for abiraterone acetate plus prednisolone (and enzalutamide) added to ADT. These data shifted first-line treatment of high-risk/metastatic disease toward combination intensification rather than ADT alone.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.