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Treatment Name: Docetaxel (Taxotere®) + Prednisone

Docetaxel (Taxotere®) + Prednisone is a Chemotherapy Regimen for Prostate Cancer

How does Docetaxel + Prednisone work?
Docetaxel is designed to directly kill prostate cancer cells. Prednisone is designed to slow the growth of prostate cancer cells by decreasing testosterone production from the adrenal glands.

Goals of therapy:
Docetaxel + Prednisone has been shown to increase survival time and improve quality of life, but is not commonly given with the goal of cure for prostate cancer. 

Schedule

  • Docetaxel intravenous (I.V.) infusion given over one hour on Day 1
  • Dexamethasone 8 mg (two x 4 mg tablets) by mouth twelve hours, three hours, and one hour before the docetaxel infusion
  • Prednisone 5 mg tablet by mouth twice daily for 21 days in a row

Docetaxel is usually given in an infusion center, or clinic. Docetaxel is repeated once every 21 days. This is known as one Cycle. Typical duration of therapy is usually until the medication no longer works or the patient cannot tolerate it.

Prednisone is usually taken at home. 

Click here for common starting doses.

Side Effects

In clinical studies the most commonly reported side effects with Docetaxel + Prednisone are shown here:

  • Anemia [low red blood cell count] (67%)
  • Hair loss (65%)
  • Fatigue (53%)
  • Nausea and Vomiting (42%)
  • Low white blood cell count (41%)
  • Infection (32%)
  • Diarrhea (32%)
  • Sensory nerve pain (30%)
  • Changes in finger and toe nails (30%)
  • Mouth pain (20%)
  • Swelling of the arms and legs (19%)
  • Change in taste (18%)
  • Loss of appetite (17%)
  • Shortness of breath (15%)
  • Muscle pain (14%)
  • Decreased heart function (decreased LVEF) (10%)
  • Tearing of eyes (10%)

Percentage of patients that discontinued the study due to unacceptable side effects was 11%

Side effect videos Side Effect Videos
AnemiaAnemiaHair LossHair LossFatigue Fatigue Nausea and VomitingNausea and VomitingNeutropenic FeverNeutropenic FeverDiarrheaDiarrheaPainPain

Monitoring

How often is monitoring needed?
Labs (blood tests) may be checked before treatment and prior to each cycle of Docetaxel + Prednisone. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), and prostate specific antigen (PSA) levels, plus any others your doctor may order.

How often is imaging needed?
A PET or CT scan may be required before treatment, or at intervals determined by your doctor.

How might blood test results/imaging affect treatment? 
Depending upon the results, your doctor may advise to continue chemotherapy as planned, or delay or switch therapy if it is not working.

ChemoExperts Tips

  • Remember to take the dexamethasone tablets the day before and day of treatment with docetaxel. This drug helps prevent infusion reactions. If you forget be sure to alert the doctor, nurse, or pharmacist at the infusion center. An intravenous dose of dexamethasone may be given if you forget a dose(s) at home
  • For twice daily prednisone tablets, take the second dose with dinner. Prednisone makes it difficult to sleep so taking the second dose earlier in the evening may help reduce trouble sleeping
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for Prostate Cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Docetaxel (Taxotere®) + Prednisone, we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Docetaxel (Taxotere®) + Prednisone. Depending upon your income, they may be able to help cover the cost of:

  • Docetaxel
  • Pred­nisone

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Docetaxel (Taxotere®) + Prednisone and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

Emotional Wellness

What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.

Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.

Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.

Learn more about pursuing emotional wellness while receiving treatment with Docetaxel (Taxotere®) + Prednisone

Individual Drug Label Information

Docetaxel (Taxotere®)

  • Docetaxel iIs an intravenous (I.V.) infusion
  • There is an increased  chance of death in patients treated with this drug who have poor liver function, are treated with higher doses, in patients with non-small cell lung cancer and a history of using other “platinum-based chemotherapy” drugs
  • Docetaxel should not be given when a certain blood cell count, neutrophils, get below 1500 cells.  The physician may hold therapy or reduce the dose and continue treatment if this occurs
  • Dosage adjustment may be required for poor liver function
  • Severe fluid retention may occur, especially when combined with prednisone
  • Docetaxel may interact with strong CYP3A4 inhibitors (e.g. ketoconazole) and proteosome inhibitors (e.g. Ritonavir) may increase concentrations of docetaxel and lead to increased toxicity or side effects. More frequent laboratory monitoring and docetaxel dosage adjustment may be needed
  • Severe hypersensitivity may occur, although rare
General Docetael (Taxotere) Side Effects
  • Hair loss
  • Low red blood cell count and fatigue
  • Nausea/vomiting
  • Diarrhea
  • Low white blood cell count and associated infections. Blood cell counts, including neutrophils (ANC) should be checked regularly
  • Nail changes on fingers and toes
  • Loss of sensation
  • Swelling in the extremities
  • Mouth sores 
  • Changes in taste
  • Loss of appetite
  • Shortness of breath
  • Muscle pain
  • Tearing of eyes or vision problems
  • Heart problems
  • Click on the docetaxel (Taxotere) package insert below for reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaHair LossHair LossFatigue Fatigue PainPainAnemiaAnemiaNeutropenic FeverNeutropenic Fever

See DailyMed package insert.

Pred­nisone

  • Prednisone is an oral medication, usually supplied as a white tablet
  • Prednisone may increase the risk of infection. Depending upon how much prednisone is taken, antibiotics may be prescribed to help prevent infections during treatment with prednisone
  • Should be taken with food and with a large glass of water to avoid stomach irritation or ulcers
  • Should be taken before 6 P.M. when possible, to avoid trouble falling asleep
  • May decrease the response to vaccines; vaccines may need to be repeated at a later date to obtain maximal response
  • If taken daily for several days or weeks, the dose of prednisone may need to be gradually decreased to avoid withdrawal symptoms
  • If you miss a dose, take the next dose as soon as possible
  • Should be stored at room temperature
General Prednisone Side Effects
  • May cause high blood sugar, weight gain, irritability, high blood pressure, difficulty sleeping, stomach ulcers, bone loss, muscle weakness
  • Click on the Prednisone package insert below for reported side effects and potential drug Interactions
See DailyMed package insert.

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References

Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med 2004;351:1502-1512.

Created: September 23, 2015 Updated: September 10, 2018

What is Prostate Cancer?

A disease of the cells found in the prostate gland in men.  Prostate cancer is a common condition caused by abnormal growth and rate changes in the prostate gland cells that form tumors.  The stage of prostate cancer can vary at diagnosis and throughout treatment.  The staging includes both the TNM + Grade, which is based on exam of tissue removed by surgery, and clinical staging: Stage I, IIa, IIb, III, IV.  The effectiveness of the treatment may depend upon the stage at diagnosis.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

Dosing Information

  • Docetaxel 75 mg/m2 IV given over one hour on Day 1; repeated every 21 days
  • Dexamethasone 8 mg (two 4 mg tablets) by mouth 12 hours, 3 hours, and 1 hour before docetaxel
  • Prednisone 5 mg tablet by mouth twice daily continuously for 21 days

LVEF - Left Ventricular Ejection Fraction

The amount of blood pumped by the left ventrical (chamber) of the heart into the body with each heartbeat.  Certain drugs can decrease heart function and result in less blood being pumped by each heartbeat than normal.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

Calcium:
14) Serum calcium

What does Cure mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.