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Paclitaxel + estramustine is a combination chemotherapy regimen investigated for the treatment of hormone-refractory prostate cancer (HRPC). Paclitaxel, a taxane, acts as a microtubule-stabilizing agent that binds to the beta-subunit of tubulin, leading to the arrest of the cell cycle in the G2/M phase and subsequent apoptosis. Estramustine phosphate sodium is a dual-action agent consisting of a conjugate of estradiol and nornitrogen mustard; it functions by binding to microtubule-associated proteins (MAPs) and tubulin to inhibit microtubule assembly, while also exerting hormonal effects through the estrogen receptor. This combination was evaluated in a Phase II clinical trial led by St. Barnabas Medical Center to determine its efficacy in patients with metastatic prostate cancer that had progressed despite hormone therapy, aiming to exploit the complementary mechanisms of microtubule disruption to overcome treatment resistance.
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