Editing Castrate-Resistant Prostate Cancer (section)

====== Asymptomatic or minimally symptomatic ======
*'''Minimally symptomatic defined as pain that is relieved by acetaminophen or a non-steroidal anti-inflammatory'''
*'''First-line (2):'''
**'''Abiraterone acetate 1000 mg/day plus prednisone 5 mg PO BID OR'''
**'''Enzalutamide 160 mg/day'''
***'''Patients who have had little or no response to hormonal agents OR who progress with minimal change in PSA OR with significant visceral metastases should be considered for early chemotherapeutic options'''
*'''Second-line: Docetaxel (75 mg/m2 every 3 weeks plus prednisone 5 mg PO BID)'''
**The timing of docetaxel therapy in men with evidence of metastases but without symptoms should be individualized based on patients’ clinical status and preferences
** '''Rising PSA only during docetaxel chemotherapy should not be used as the sole criteria for progression; assessment of response should incorporate clinical and radiographic criteria'''