What is the role of chemohormonal regimens in the treatment of hormone-refractory prostate cancer?

Updated: Dec 29, 2020
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

The rationale behind chemohormonal regimens for hormone-naive advanced disease is based on earlier exposure of prostate cancer to cytotoxic chemotherapy, before clonal expansion of androgen-independent cells or constitutive expression of cell survival genes becomes established and before patients develop hormone-refractory prostate cancer. In the past, chemotherapy for prostate cancer was found to be ineffectual. However, developments with antimicrotubule agents and inhibition of tyrosine kinase show promise.

Docetaxel is the drug of choice over mitoxantrone in patients with advanced prostate cancer that has become hormone refractory. In a phase 3 trial, Tannock et al demonstrated that docetaxel plus prednisone every 3 weeks improved patient survival by 3 months over mitoxantrone plus prednisone. [43] As secondary endpoints, the investigators found that patients also had an improved PSA response, decreased pain, and better quality of life.


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