Continuous versus intermittent docetaxel for metastatic castration resistant prostate cancer

• Debate exists on the optimal number of DTX cycles for mCRPC patients.
• Many trials have explored the feasibility of intermittent DTX (IC) in this setting.
• We comprehensively review the evidence for using IC in mCRPC.
• With multiple newer drugs available, the benefit of continuous DTX is uncertain.
• IC is a feasible treatment option in mCRPC.

Docetaxel (DTX) is a standard chemotherapeutic agent for metastatic castration resistant prostate cancer (mCRPC). However, given a number of toxicities associated with DTX, considerable debate exists regarding the optimal number of DTX cycles to be administered in this setting. In clinic, it is a usual practice to continue DTX until toxicities or disease progression precludes its administration. Therefore, we undertook a comprehensive review of the literature on intermittent versus continuous chemotherapy administration in this setting. Although there is no head-to-head comparison of these two approaches, our review discovered many studies which show that intermittent approach is a very feasible and attractive option with lower toxicities and better quality of life. Because of the availability of many newer agents that can be used post-docetaxel, stopping DTX early seems to be more appropriate with introduction of docetaxel or newer agents upon progression. This review summarizes the data from available studies regarding the feasibility and controversies of intermittent docetaxel in prostate cancer.