Is "off-protocol" chemotherapy for androgen-independent carcinoma of prostate warranted?

It is acceptable to treat HRPC patients with off-protocol chemotherapy if these patients do not accept protocol therapy or are ineligible for such therapy. The choice of cytotoxic agent needs to be individually assessed, depending on range of tolerable toxicities and personal preferences of the physician and patient. At the present time, single-agent therapy with oral or intravenous cyclophosphamide or mitoxantrone/prednisone may offer optimal palliation without undue side effects in a predictable number of patients.