Does docetaxel plus prednisone prolong the survival of men with metastatic hormone-refractory prostate cancer?

Andrew Protheroe

This article has no abstract so we have provided the first paragraph of the full text.

Prostate cancer is the most common cancer affecting men, with more than 30,000 new cases diagnosed each year in the UK. Once the disease becomes hormone refractory, the options for standard systemic therapy are very limited. Up until the mid 1990s chemotherapy was felt not to be effective for men with prostate cancer. Various reasons for this included difficulty in measuring objective response, PSA measurements not being routinely taken and co-morbidity within this patient population. In 1996, the seminal paper by Tannock and colleagues first demonstrated that chemotherapy does indeed have a significant role. This study demonstrated a benefit using pain assessment as an endpoint, but not for overall survival. The improvement in palliation of bone pain was 29% vs 12% (P=0.01) for the combination. Mitoxantrone and prednisone became the standard of care. Other studies similarly demonstrated a benefit for PSA response and pain improvement,² and for PSA response and improved time to treatment failure,³ but no improvement in survival. As a consequence mitoxantrone chemotherapy, whilst used in many centers, was and is not used in all.

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