Abstract
Hormone-refractory prostate cancer (HRPC), defined as progression of disease in the setting castrate testosterone levels, is associated with significant morbidity and a dismal prognosis. Historically, the paradigm for treatment of HRPC focused on palliation because of the lack of available therapies that improved survival. The taxanes, chemotherapeutic agents that stabilize microtubules, thereby preventing further cell division, demonstrated efficacy in the treatment of HRPC in phase I and phase II studies. In addition, taxane-based therapies palliated disease complications with minimal toxicity. Two randomized studies, SWOG 9916 and TAX 327, were the first trials to establish the survival benefit of docetaxel for men with progressive HRPC. As the literature describing the benefit of taxane-based chemotherapy for metastatic disease has grown, the role of these therapies for neoadjuvant and adjuvant treatment of high-risk localized disease are being investigated. The future of taxanebased treatment lies in combination strategies with biological and targeted therapy, including agents targeting angiogenesis, the endothelin receptor, and other signal pathways to help overcome drug resistance and improve clinical outcomes for patients with HRPC.
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