Personalizing the Path in mCRPC: Optimizing Chemotherapy and Aggressive Variant Prostate Cancer (AVPC) - Episode 3
Individualizing Chemotherapy: Dosing, Tolerability, and Treatment Duration
A panel of experts discuss cabazitaxel monitoring strategies (PSA kinetics, imaging, symptom assessment, neutropenia, fatigue, dose adjustments) and perspectives on FDA's overall survival emphasis relative to progression-free survival benefits in therapies like 177Lu-PSMA-617, including patient expectations, tolerability, and shared decision-making.
Expert discussion centers on practical monitoring strategies for patients receiving cabazitaxel, emphasizing PSA kinetics, interval imaging, and symptom assessment to guide ongoing therapy. Clinicians highlight the importance of proactively managing toxicities—particularly neutropenia and fatigue—through growth factor support, dose reductions, and schedule modifications to maintain tolerability. The panel also explores FDA prioritization of overall survival over progression-free survival, using agents such as ^177Lu-PSMA-617 as examples. Patient expectations, quality of life, and shared decision-making are underscored as critical factors when balancing modest survival gains against treatment burden.