Ever since docetaxel was shown to be the first known agent to extend survival in men with metastatic castration-resistant prostate cancer (mCRPC),1 drug development efforts have focused on do-cetaxel as apivotpoint for trial design and regulatory approval. To this end, the majority of phase III clinical trials conducted in the postdo-cetaxel era have investigated the use of novel agents either before docetaxel administration, combinedwithdocetaxel, or after docetaxel exposure.2 Although this divide is an artificial one biologically, it has been embraced by regulatory agencies for the approval of several new drugs for mCRPC in the past 3 years. However, although new agents have been approvedboth in the predocetaxel setting (eg, sipuleucel-T, abiraterone) and in the postdocetaxel setting (eg, cabazitaxel, abi-raterone, enzalutamide) on the basis of improvements in overall sur-vival, no drug has yet demonstrated a survival benefit (or gained regulatory approval) when combined with docetaxel.
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Antonarakis et al. (2013) studied this question.
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