© 2004 European Society for Medical Oncology
Chemotherapy for patients with hormone-refractory prostate cancer
Department of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, 610, University Avenue, Toronto, ON M5G 2M9, Canada
* Email: ian.tannock@uhn.on.ca
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Recognition that chemotherapy can provide useful palliation for patients with hormone-refractory prostate cancer (HRPC) is relatively recent. Most early clinical trials either evaluated response to chemotherapy in (the relatively rare) patients with measurable disease or used criteria developed by the National Prostate Cancer Project (NPCP), where response included ‘stable disease’ on bone scans [1
]. These criteria could not separate patients who were experiencing meaningful effects of chemotherapy from those with slow progression of disease that was not influenced by treatment. Patients with HRPC are often elderly, and have co-morbid conditions, so that chemotherapy is relatively toxic. In the mid-1980s, two reviews of this prior experience suggested that there was no routine role for chemotherapy in the management of HRPC and that it should only be used in the context of a well-designed clinical trial [2, 3]. More recently, the role of chemotherapy has been revisited with the