Out Of The Ordinary Though Possible AZD4547 Strategies

Although published data are available Cisplatin chemical structure from 44 phase II trials of chemotherapy in docetaxel-resistant mCRPC, the results of many of these trials have been disappointing.24 There are only two phase III randomized controlled studies of cytotoxic agents in this setting (Table?1) �C SPARC25 and TROPIC.14 In the SPARC study patients with mCRPC (only half of whom were docetaxel pretreated) were allocated to receive either satraplatin and prednisone (n?=?635) or placebo and prednisone (n?=?315).25 Although satraplatin delayed disease progression (progression-free survival: 11.0 vs 9.7?weeks; HR 0.67; 95% CI 0.57�C0.77, P?AZD4547 purchase in cancer cells that are resistant to docetaxel.27 In the TROPIC study, cabazitaxel was associated with a 30% reduced risk of death, prolonging survival from 12.7 to 15.1?months (HR 0.70; 95% CI 0.59�C0.83, P?INPP5D and in those who had received high cumulative doses of docetaxel (n?=?134; HR 0.51; 95% CI 0.33�C0.79). Post hoc subgroup analysis of the TROPIC trial shows that a similar proportion of patients discontinued prior docetaxel due to disease progression (63 and 61% in the cabazitaxel and mitoxantrone arms, respectively).28 In this subgroup of patients, median overall survival was greater with cabazitaxel than with mitoxantrone (13.8 vs 10.9?months; HR 0.70; 95% CI 0.57�C0.87). Survival benefit with cabazitaxel was also evident among patients who had discontinued prior docetaxel for reasons other than disease progression (18.0 vs 15.6?months; HR 0.63; 95% CI 0.46�C0.85). This suggests that the survival benefit of cabazitaxel over mitoxantrone is maintained irrespective of whether prior docetaxel treatment was discontinued due to disease progression.