Advances in Therapy

, Volume 30, Issue 12, pp 1041–1066

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


    • Clatterbridge Cancer Centre NHS Foundation Trust
  • Heather Payne
    • University College London Hospitals
  • Jawaher Ansari
    • Beatson West of Scotland Cancer Centre
  • Simon Chowdhury
    • Guy’s and St Thomas’ NHS Foundation Trust
  • Mohammad Butt
    • Queens Centre for Oncology and HaematologyCastle Hill Hospital
  • Alison Birtle
    • Rosemere Cancer CentreLancashire Teaching Hospitals
  • Santhanam Sundar
    • Nottingham University Hospitals NHS Trust
  • Chinnamani Vee Eswar
    • Clatterbridge Cancer Centre NHS Foundation Trust
  • Simon Hughes
    • Guy’s and St Thomas’ NHS Foundation Trust
  • Amit Bahl
    • Bristol Haematology and Oncology Centre

DOI: 10.1007/s12325-013-0070-z

Cite this article as:
Malik, Z., Payne, H., Ansari, J. et al. Adv Ther (2013) 30: 1041. doi:10.1007/s12325-013-0070-z


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.


Abiraterone acetateCabazitaxelEnzalutamideRadium-223Metastatic castration-resistant prostate cancerOncologySipuleucel-TTreatment sequencing

Supplementary material

12325_2013_70_MOESM1_ESM.pdf (193 kb)
Supplementary material (PDF 193 kb)

Copyright information

© Springer Healthcare 2013