© 2000 Kluwer Academic Publishers. Printed in the Netherlands. Review Chemotherapy in advanced androgen-independent prostate cancer

studies have been reported in the field of chemotherapy for advanced androgen-independent prostate cancer during the last ten years. The aims of the present review were to assess their impact on management of the disease and on survival of patients. Methods: The review of full published reports was facilited by the use of a MEDLINE computer search. Results: Clinical research studies have focused on defining guidelines for eligibility criteria and accurate endpoints for patients to be enrolled onto clinical trials and developing new agents or combination of drugs including estramustine phosphate. Any combination of current chemotherapy has no impact on overall survival of patients. Among drugs in devel-opment, only the promising activity observed with docetaxel deserves randomized trials to assess its impact on survival. The major innovative advance of the 90s is the demonstration of the impact of chemotherapy (mitoxantrone + prednisone) on quality of life as compared to prednisone alone. A greater and longer-lasting improvement in quality of life along with a concomitant decrease in costs was observed. Conclusions: At the present time, chemotherapy should be considered as a palliative treatment in patients with sympto-matic androgen-independent disease. The enrollment of pa-tients into clinical trials dealing with quality of life as primary endpoint is strongly solicited. A standard methodology should be used in phase II trials with a primary goal of selection of agents which should progress to randomized trials using sur-vival as an endpoint. Hopefully new specific strategies targeted to reverse the molecular changes that underlie prostate tumori-genesis should rapidly impact the multimodality management of AIPC in the third millenium. Key words: androgen-independent prostate cancer, chemo-therapy, metastatic prostate cance