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Evolution of the Treatment Paradigm for Patients with Metastatic Castration-Resistant Prostate Cancer

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Abstract

As recently as 2004, treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) were limited, with docetaxel the only approved agent conferring a survival benefit. The therapeutic landscape is now very different, with several agents demonstrating prolonged survival since 2010. New agents for the treatment of mCRPC include sipuleucel-T, cabazitaxel, abiraterone acetate, enzalutamide and radium-223. All are now approved for use in this patient group, although the specific licensing terms vary between agents. In addition, denosumab may have utility in patients with bone metastases. A number of novel agents are also in development with promising initial results. However, because these treatment options have proliferated rapidly, there is currently a paucity of clinical evidence regarding their optimal sequencing. Selection of an appropriate treatment option should take into consideration disease characteristics, drug availability and patient choice. In summary, we discuss several new treatment options available for mCRPC and their integration into the current treatment paradigm.

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Acknowledgments

We thank Ben Caldwell of MediTech Media Ltd, who provided medical writing services, funded by Sanofi. The authors retained full editorial independence and were wholly responsible for the decision of whether and to which journal the manuscript should be submitted. Dr. Malik is the guarantor for this article, and takes responsibility for the integrity of the work as a whole. The publication charges for the article were also funded by Sanofi.

Conflict of interest

Dr. Malik has received honoraria for speaker meetings and advisory boards from Astellas, AstraZeneca, GSK, Janssen, Novartis, Pfizer and Sanofi. Dr. Payne has received honoraria for speaker meetings and advisory boards from Astellas, AstraZeneca, GSK, Janssen, Novartis, Ferring, Takeda, Ipsen and Sanofi. Dr. Ansari has received honoraria for speaker and advisory board meetings for Sanofi, and for advisory board meetings for Janssen and Astellas. Dr. Chowdhury has received honoraria for advisory boards from Janssen and Sanofi. Dr. Sundar has received honoraria for speaker meetings and advisory boards from Astellas, AstraZeneca, Amgen, Janssen and Sanofi. Dr. Bahl has acted in a consultant/advisory role for Sanofi, and has received honoraria and research funding from Sanofi. Dr. Birtle has received an educational grant from Sanofi and honoraria for advisory boards from Astellas, Janssen and Sanofi. Dr. Hughes has received honoraria from Pierre-Fabre, Sanofi, Pfizer, Janssen, Astellas, AstraZeneca and Boehringer Ingelheim. Dr. Butt and Dr. Eswar have no conflicts of interest. Dr. Malik conceived of the manuscript and drafted the manuscript with the assistance of the medical writer. Dr. Payne, Dr. Ansari, Dr. Chowdhury, Dr. Butt, Dr. Birtle, Dr. Sundar, Dr. Eswar, Dr. Hughes and Dr. Bahl reviewed each draft for critical content. All authors read and approved the final manuscript for publication.

Compliance with ethics guidelines

The analysis in this article is based on previously conducted studies, and does not involve any new studies of human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, Wirral, Merseyside, CH63 4JY, UK

    Zafar Malik & Chinnamani Vee Eswar

  2. University College London Hospitals, London, UK

    Heather Payne

  3. Beatson West of Scotland Cancer Centre, Glasgow, UK

    Jawaher Ansari

  4. Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Simon Chowdhury & Simon Hughes

  5. Queens Centre for Oncology and Haematology, Castle Hill Hospital, Hull, UK

    Mohammad Butt

  6. Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK

    Alison Birtle

  7. Nottingham University Hospitals NHS Trust, Nottingham, UK

    Santhanam Sundar

  8. Bristol Haematology and Oncology Centre, Bristol, UK

    Amit Bahl

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  1. Zafar Malik
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Correspondence to Zafar Malik.

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Malik, Z., Payne, H., Ansari, J. et al. Evolution of the Treatment Paradigm for Patients with Metastatic Castration-Resistant Prostate Cancer. Adv Ther 30, 1041–1066 (2013). https://doi.org/10.1007/s12325-013-0070-z

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