This article addresses the current status of therapeutic options in the management of hormone-refractory prostate cancer (HRPC). Following the publication of two landmark randomised trials, docetaxel chemotherapy is now the standard of care for men with metastatic HRPC. However, the benefit of this treatment is limited. Trials are now focusing on improving the efficacy of docetaxel by combining it with novel biological agents. Several new docetaxel-based combinations are under evaluation and promising results have been found for the combination of docetaxel with angiogenesis inhibitors. Early phase III trial data for atrasentan appear interesting. New cytotoxic agents such as satraplatin and ixabepilone are being investigated in several ongoing studies in order to define their role as second-line treatments of HRPC. Vaccine therapy offers an active immunological approach for combating malignancy in a targeted manner.