Docetaxel-based regimens, the standard of care for metastatic androgen-insensitive prostate cancer

Patients with recurrent prostate cancer may be treated with androgen deprivation strategies; however, most patients will develop androgen-independent prostate cancer. Strategies for treatment of this group of patients have shown significant palliation but until recently, have had no definitive increase in survival. Two large Phase III studies evaluating docetaxel-based chemotherapy were initiated to see if these could improve overall survival over mitoxantrone with prednisone. The purpose of the Tax 327 Phase III study was to determine if either weekly or every-3-week administration of docetaxel plus daily prednisone regimen could improve the overall survival for these patients as compared with mitoxantrone and prednisone, which is approved by the US Food and Drug Administration as a palliative treatment. This study is of immense importance as it represents the first time any treatment has been shown to improve overall survival in an appropriately powered study in patients with androgen-insensitive metastatic prostate cancer. Newer approaches are now looking at combinations of other drugs with docetaxel to further improve the overall survival of patients with metastatic androgen-insensitive metastatic prostate cancer.