The treatment of hormone-refractory prostate cancer

Note: The information provided below is basic information only. The content of this section will be upgraded in the near future to offer a more detailed commentary on the treatment of hormone-refractory prostate cancer.

So-called “hormone-refractory” prostate cancer or HRPC (also known as “androgen-independent” prostate cancer or AIPC) is prostate cancer that is no longer responding to hormonal therapy.

Until very recently there were no good therapeutic options for men with this stage of prostate cancer. Indeed, all that was available to treat these men were forms of therapy used to try to manage the severe pain associated with their bone and soft tissue metastases (“palliative therapy”). This all changed in 2004.

That year, two large clinical trials provided results that radically changed the management of hormone-refractory disease (and indeed the potential for treatment of all forms of advanced prostate cancer). These two studies were known as TAX 327 and SWOG 99-16. They were the first two major studies ever to show a clinically significant survival benefit for any form of chemotherapy in the treatment of any stage of prostate cancer.

de Wit has recently reviewed the role of chemotherapy in the treatment of hormone-refractory prostate cancer.

Since the publication of the results of these two clinical trials, standard therapy for the management of HRPC has become the combination of docetaxel (Taxotere) and prednisone given daily for 3 weeks for 8 cycles of therapy. However, literally dozens of other trials are now seeking to improve on the average survival benefit offered by this combination (which is only a matter of 2 months compared to prednisone alone).

We can now expect to see significant changes in the way all forms of advanced prostate cancer are treated over the next few years, as various docetaxel-based regimens are tried in the treatment of every nonlocalized stage of the disease, and as additional chemotherapy-based regimens are used in the treatment of HRPC.

It is also worth noting that there are the very earliest suggestions that (just as in the case of homrone therapy) intermittent Taxotere-based chemotherapy may also be a real possibility (see the blog post “Chemotherapy for HRPC: intermittent docetaxel“).

Content on this page last reviewed and updated April 5, 2008.
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