ABSTRACT
Androgen ablation was identified as effective for the treatment of metastatic prostate cancer more than 60 years ago. Rapid and dramatic regression of metastatic lesions follow the achievement of castrate testosterone levels; this response generally lasts 18-24 months, with almost all patients experiencing disease progression. Once patients become refractory to androgen blockade, their prognosis is dismal, with a median survival time of 9-12 months. An estimated 31 000 men will die from metastatic disease in the year 2002. Unfortunately, until recentiy few treatment options were available to men with hormonerefractory prostate cancer (HRPC). Single-agent chemotherapy has been, in the past, viewed as ineffective. A review by Yagoda and Petrylak of single-agent chemotherapeutic trials published between 1988 and 1991 demonstrated a disappointing response rate of 8.7% (95% confidence interval 6.4-9.0%), with median survivals of 912 months1. This review demonstrated the need for new agents and drug targets.
