Durable Complete Response to Frontline Docetaxel in an Advanced Prostate Cancer Patient with Favourable CYP1B1 Isoforms: Suggestion for Changing Paradigms?

Docetaxel is currently indicated for androgen-independent, metastatic prostate cancer; there is also evidence demonstrating the role of CYP1B1 in modulating the activity of the drug. We present the case of a man with residual disease after radical prostatectomy treated successfully with docetaxel chemotherapy. After only two cycles of therapy, a complete remission was obtained and then consolidated with additional cycles of docetaxel and radiotherapy. Prospective genetic analysis had shown that the patient had a favourable CYP1B1 genotype. He has been disease free since August 2006. Prospective trials investigating this strategy are warranted.