Chemotherapy for androgen-independent prostate cancer.

The evolution of taxanes as treatment for androgen-independent prostate cancer hes emerged from both the laboratory and clinic. Docetaxel is a potent in vitro inhibitor of Bcl-2, an antiapoptotic gene. Phase I and II studies with docetaxel alone or in combination with estramustine demonstrated promissing median survivals of 14--23 months, higher than what would have been expected for historic controls. Two randomized trials have proven the superiority of docetaxel based treatment in improving survival in men with androgen-independent prostate cancer. SWOG 99-16 and TAX 327 found that docetaxel-based therapy reduced the risk of death by 20--24% when compared to mitoxantrone-based therapy. Future trials will build on docetaxel-based combinations with novel targeted agents.