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80 yo w/ extensive bone mets, recent complaints of pain, fatigue, weight loss (PS = 2)?80 yo w/ extensive bone mets, recent complaints of pain, fatigue, weight loss (PS = 2)?An 80-year-old man presents de novo with a PSA of 50 ng/mL, extensive bony metastases and recent complaints of pain, fatigue and weight loss (PS = 2) that are believed to be cancer related. What systemic treatment approach would you generally recommend, and what bone-targeted treatment, if any, would you recommend at this time? Berthold DR et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: Updated survival in the TAX 327 study. J Clin Oncol 2008;26(2):242-5. Abstract Italiano A et al. Docetaxel-based chemotherapy in elderly patients (age 75 and older) with castration-resistant prostate cancer. Eur Urol 2009;55(6):1368-75. Abstract Petrylak DP et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 2004;351(15):1513-20. Abstract Sweeney C et al. Impact on overall survival (OS) with chemohormonal therapy versus hormonal therapy for hormone-sensitive newly metastatic prostate cancer (mPrCa): An ECOG-led phase III randomized trial. Proc ASCO 2014;Abstract LBA2. Tannock IF et al; TAX 327 Investigators. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004;351(15):1502-12. Abstract |