title: Second-line chemotherapy in metastatic docetaxel-resistant prostate cancer: a review.
abstract: The results of cytotoxic therapy in the second-line setting of metastatic castration-resistant prostate cancer have demonstrated that disease is poorly controlled after taxane resistance with a time to progression of 3 months or less. Many trials of second-line chemotherapy have been disappointing. However, most of patients with docetaxel-pretreated castration-resistant disease receive a second-line chemotherapy. Molecular mechanism of castration resistance and docetaxel resistance is resumed, and clinical trials of second-line chemotherapy after docetaxel progression are reviewed. Reintroduction of docetaxel after a drug-free interval is an active treatment in docetaxel-pretreated patients, and only recently a prospective study documented a survival benefit of 2.4 months after second-line taxane-based chemotherapy of metastatic docetaxel-resistant prostate cancer. Although a second-line chemotherapy with a taxane could improve overall survival, a change of biology of castration-resistant prostate cancer after docetaxel is suggested, as inferred by the renewed hormonal sensitivity, whose role on survival remains unknown, and from the activity of antiangiogenic drugs.
authors.affiliation: Division of Medical Oncology, "Giovanni Borea" Hospital, Via Giovanni Borea n. 56, 18038 Sanremo, Imperia, Italy. g.colloca@katamail.com
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colloca
authors.forename: Antonella
authors.initials: A
authors.lastname: Venturino
authors.forename: Franco
authors.initials: F
authors.lastname: Checcaglini
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D016879:Salvage Therapy; D043823:Taxoids / Q000494:pharmacology*
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel