Hormone refractory prostate cancer: Management and advances.

Effective therapeutic options have not existed for prostate cancer progressing after androgen deprivation therapy until very recently. Secondary hormonal manipulations offer marginal benefits. Docetaxel based chemotherapy has been demonstrated to extend survival and change the natural history of the disease in two large randomized trials. These studies have provided the impetus to combine docetaxel with novel biologic agents to further consolidate the gains in long-term outcome. With the arrival of exciting agents including vaccines, monoclonal antibodies, bone-targeted drugs, antisense oligonucleotides, anti-angiogenic drugs and small molecule receptor tyrosine kinase inhibitors, the future treatment of prostate cancer appears promising.