Single-agent chemotherapy with docetaxel significantly reduces PSA levels in patients with high-grade localized...

Chemotherapy has been shown to be effective in the management of prostate cancer in patients with androgen-independent metastatic disease, however, a survival benefit has not been demonstrated yet. Docetaxel alone or in combination with estramustine has been shown to exhibit a high level of activity in the treatment of hormone-refractory prostate cancer. To date there are only few reports on chemotherapy for localized prostate cancer.

The efficacy and safety of neoadjuvant chemotherapy with docetaxel as a single agent given prior to radical retropubic prostatectomy (RRP) has been evaluated in 5 patients presenting with Gleason score 8 prostate cancers at biopsy.

The mean reduction in prostate-specific antigen levels in the 5 patients was 66.5% (range 47.6-94.0%). Histology after RRP yielded pT2N0MxR0 prostate cancers in all subjects. Testosterone and secretoneurin levels were not significantly affected by docetaxel monotherapy.

Although the use of neoadjuvant chemotherapy prior to RRP is still experimental, the dramatic prostate-specific antigen decrease during chemotherapy and the pathologic findings after radical prostatectomy are encouraging. Studies including larger number of patients will have to confirm the present results.