Present status and perspectives in the treatment of hormone-refractory prostate cancer

The cornerstone in the treatment of de novo or recurrent metastatic prostate cancer is androgen deprivation. Unfortunately, nearly all patients will develop androgen-independent ('hormone-refractory') disease with progressive clinical deterioration and ultimately death. Chemotherapy has been shown to palliate symptoms of hormone-refractory disease but not to improve survival. Recently, two large phase III trials have demonstrated an overall survival advantage for patients treated with docetaxel-based regimens as compared to the best standard of care. Indeed, investigations into the pathophysiology of this malignancy, novel biological agents, skeletal protectants and radiopharmaceuticals are expanding the clinician's armamentarium and improving the patient's outcome.