Evolution of docetaxel-based therapy for metastatic castrate-resistant prostate cancer

Until the publication of the SWOG 99-16 [1] and TAX 327 [2] trials in 2004, urologists understood that only purely palliative treatment was available for men with prostate cancer that was progressive despite androgen deprivation. However, following the establishment of docetaxel-based chemotherapy as an active treatment option for most men with metastatic disease, researchers have focused their questions on the optimal timing of treatment. Should docetaxel be considered after one or two lines of hormone manipulation? Is it necessary to wait until the patient has bone pain? In latter years, the research focus has widened to embrace second-line and even third-line chemotherapy for this patient group, raising the possibility of advanced prostate cancer being managed as a chronic condition. This article looks at the evolution of docetaxel-based chemotherapy in advanced prostate cancer, and considers the next likely developments. (C) 2010 British Association of Urological Surgeons. Published by Elsevier Ltd. All rights reserved.