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86

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

Guide 23. Treatment after docetaxel

Options if no metastases in internal organs

• Enzalutamide

• Abiraterone acetate with prednisone

• Cabazitaxel with prednisone

• Radium-223 for bone metastases causing symptoms

• Sipuleucel-T

• Clinical trial

• Docetaxel rechallenge

• Alternative chemotherapy (mitoxantrone with prednisone)

• Secondary hormone therapy

◦◦ Antiandrogen

◦◦ Antiandrogen withdrawal

◦◦ Ketoconazole ± hydrocortisone

◦◦ Corticosteroid

◦◦ DES or other estrogen

• Best supportive care

Options if metastases in internal organs

• Enzalutamide

• Abiraterone acetate with prednisone

• Cabazitaxel with prednisone

• Clinical trial

• Docetaxel rechallenge

• Alternative chemotherapy (mitoxantrone with prednisone)

• Secondary hormone therapy

◦◦ Antiandrogen

◦◦ Antiandrogen withdrawal

◦◦ Ketoconazole ± hydrocortisone

◦◦ Corticosteroid

◦◦ DES or other estrogen

• Best supportive care

7

Treatment guide: Systemic treatment

Castration-recurrent prostate cancer