Clinical pharmacology and pharmacogenetics of chemotherapy in prostate cancer

Cytotoxic chemotherapy using docetaxel, estramustine, and mitoxantrone is often employed to treat men with hormone-refractory prostate tumors. More recently, oral satraplatin has been studied as an alternative to docetaxel-based therapies. These cytotoxic agents have diverse mechanisms of action and disposition. Moreover, there is often wide interindividual variation in the pharmacokinetics, toxicity, and clinical outcome following administration of these agents in patients with prostate cancer. This chapter summarizes what is known about the basic clinical pharmacology of these agents and discusses the mechanisms and implications of interindividual variation in treatment.