Prolonged survival of patients with castration-resistant prostate cancer has been demonstrated following treatment with a combination of docetaxel and prednisone. This combination has, therefore, become the standard first-line chemotherapy for castration-resistant prostate cancer. Median survival, however, does not exceed 20 months and there are currently no approved second-line treatments for patients who progress after docetaxel treatment. The development of effective and safe treatment strategies is urgently required. Several clinical trials are currently evaluating the use of cytotoxic, antiandrogenic and molecular targeting agents. Preclinical studies are identifying the mechanisms responsible for docetaxel resistance and means of enhancing docetaxel activity. The results of these studies will provide the basis for rationally designed therapeutic approaches. This article summarizes the results of recent preclinical and clinical studies and discusses future perspectives.
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