Table 3.

Proposed strategies to improve efficacy of taxanes in prostate cancer

Strategy	Description
Intermittent administration	Intermittent dosing of chemotherapy may allow time for patients to recover from toxicity and tolerate more prolonged treatment, which could improve long-term outcomes Break periods could be used to employ other therapies such as biologic or hormone-based treatments to delay time to taxane resistance
Combination therapy with platinum-based therapy	Joint targeting of microtubules and DNA may improve outcomes Phase II data suggest some patients may have improved responses to taxanes after a platinum agent has been added
Combination with angiogenesis inhibition	Although phase III data of a taxane with angiogenesis inhibition did not improve survival, substantial data support the importance of neovascular growth in prostate cancer Promising phase II data with a taxane and 2 antiangiogenesis agents may suggest that a maximal antiangiogenic blockade can enhance taxane-based therapy
Combination with novel hormonal agents	Changes in the AR signaling cascade may contribute to taxane resistance Combination therapies of taxanes with novel hormonal agents may delay the development of taxane-resistant prostate cancer
Combination with a radiopharmaceutical	Targeting the microenvironment of metastatic bone lesions with bone-targeted radiopharmaceuticals may enhance the clinical efficacy of systemic taxane-based therapy