Unfortunately, hormonal therapy is not curative, and even though some patients may respond for long periods, on average about 3-7 years pass, and the PSA no longer responds and disease progresses. The question of whether adding chemotherapy to this can improve outcomes is being asked by several studies. One such study from Europe has now been reported at the GU Cancer Symposium and shows ~10% improvement in PSA responses but at the expense of higher toxicity (and obviously higher cost). There is also a longer time to PSA progression. However, the overall survival analysis has not yet been done. We continue to enter patients into the U.S. trial evaluating this same question.