Abstract

Following endocrine therapy, progression to a hormone-refractory state is inevitable in patients with locally advanced or metastatic prostate cancer, if they survive competing mortality. Current treatment options are essentially palliative, with the aim of maintaining quality of life and prolonging survival. Following the failure of primary androgen ablation, a number of treatment strategies are available. Exploitation of the anti-androgen withdrawal syndrome and further hormonal therapies are well-established treatments. More recently, interest in chemotherapy has been renewed owing to demonstrable benefits in prostate specific antigen (PSA) response and pain palliation, albeit without any improvements in survival. However, future treatment options that can prolong survival and maintain quality of life for patients with hormone-refractory prostate cancer (HRPC) are constantly being sought. An increased understanding of the molecular biology of prostate cancer has led to the identification of novel targets and agents. The evaluation of these, and possible addition of them to our armamentarium against prostate cancer, is the goal of ongoing clinical trials.

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