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Evolving role of chemotherapy in castration-resistant prostate cancer

Fatima H Karzai, Ravi A Madan and William L Dahut

The role of chemotherapy in castration-resistant prostate cancer has evolved greatly over the past several decades. However, at this time, docetaxel remains the only first-line chemotherapy option that improves survival. More recently, the novel taxane cabazitaxel (plus prednisone) was found to prolong overall survival in metastatic castration-resistant patients who had progressed during or after docetaxel therapy. The addition of new hormonal agents, immunologic-based therapies, angiogenesis inhibitors and other small molecules to docetaxel is under investigation. To date, the results of such combination therapies have been disappointing but there is a significant optimism surrounding the ongoing studies.