Prostate cancer and chemotherapy.

Despite the increase in the number of patients presenting today with clinically localized prostate cancer who undergo definitive local therapy (either radiation therapy or radical prostatectomy), approximately 50% will experience advanced disease recurrence.1,2 In these patients or patients presenting initially with advanced disease, suppression of androgenic activity with either surgical or medical castration (with luteinizing hormone-releasing hormone [LHRH] analogues) with or without antiandrogens is usually regarded as first-line treatment.3,4 Unfortunately, hormonal therapy is only palliative and successful in 70% to 80% of patients, with a median duration of response of 12 to 24 months.3,4 For patients who progress on LHRH analogues and antiandrogens, the withdrawal of antiandrogens results in a prostate-specific antigen (PSA) decline in 25% to 50% of patients.5 Other secondary hormonal options include the use of ketoconazole and hydrocortisone, the addition of an antiandrogen in patients progressing despite administration of an LHRH analogue alone, and corticosteroids.6 Although secondary hormonal manipulations can produce a subjective response in approximately 25% of patients, the response is only short lived (approximately 4 months).7 This problem has prompted numerous studies to evaluate the potential use of chemotherapy for patients with hormone-resistant prostate cancer (HRPC). To this end, docetaxal, a member of the taxane family, has recently been shown to have marked activity against prostate cancer cells both in vitro and in vivo.8,9 The following recently published articles report on the potential use of docetaxel either as monotherapy or as a part of combination therapy in the management of HRPC.