The use of Ketoconazole (Keto) in men with advanced prostate cancer is not considered mainstream, however there is clear evidence that it does reduce PSA in men with castrate resistant prostate cancer. Currently, most men with advanced prostate cancer who do use Keto utilize it prior to chemotherapy. There has been little literature evaluating the possible role of Keto in men who have failed chemotherapy with taxotere (chemo failure).

Shah etal. Performed a study designed to evaluate the efficacy of Keto in men with castrate resistant prostate cancer, both pre and post chemotherapy. They looked at men who received Keto therapy between January 1, 1999 and September 30, 2009. Men included in the analysis had failed androgen deprivation therapy (ADT) and were subsequently initiated on ketoconazole.

Nominal data was evaluated with Fisher’s Exact Test and continuous data was evaluated with Mann Whitney U or log rank tests. The primary objective of this study was to evaluate PSA response (PSA decline ?50% maintained at least 4 weeks) in men receiving Keto Therapy with or without prior docetaxel therapy.

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