The extensive experience with cytotoxic chemotherapy in cancer of the prostate is summarized in this review. The overall results indicate that clinical benefits are modest and survival of hormone refractory patients remains poor and unaffected by chemotherapy. Emphasis should focus on new drug development and investigators should attempt to study the effects of new treatments under more optimal conditions, i.e. in patients with limited prior treatment, less extensive disease and good performance status. Efforts should also concentrate on the development of reliable and reproducible endpoints to define therapeutic efficacy in this disease, including new instruments to measure quality of life. Is is clear that new advances in the treatment of this disease are very much dependent on the identification of effective non-endocrine approaches and a better understanding of the mechanisms involved in the development of endocrine and chemotherapy resistance. Multidisciplinary interactions undoubtedly form the "core" for productive research in this area.
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