Advances in Therapy

, Volume 30, Issue 12, pp 1041–1066 | Cite as

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

  • Zafar Malik
  • Heather Payne
  • Jawaher Ansari
  • Simon Chowdhury
  • Mohammad Butt
  • Alison Birtle
  • Santhanam Sundar
  • Chinnamani Vee Eswar
  • Simon Hughes
  • Amit Bahl


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 acetate Cabazitaxel Enzalutamide Radium-223 Metastatic castration-resistant prostate cancer Oncology Sipuleucel-T Treatment sequencing 

Supplementary material

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


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Copyright information

© Springer Healthcare 2013

Authors and Affiliations

  • Zafar Malik
    • 1
  • Heather Payne
    • 2
  • Jawaher Ansari
    • 3
  • Simon Chowdhury
    • 4
  • Mohammad Butt
    • 5
  • Alison Birtle
    • 6
  • Santhanam Sundar
    • 7
  • Chinnamani Vee Eswar
    • 1
  • Simon Hughes
    • 4
  • Amit Bahl
    • 8
  1. 1.Clatterbridge Cancer Centre NHS Foundation TrustWirralUK
  2. 2.University College London HospitalsLondonUK
  3. 3.Beatson West of Scotland Cancer CentreGlasgowUK
  4. 4.Guy’s and St Thomas’ NHS Foundation TrustLondonUK
  5. 5.Queens Centre for Oncology and HaematologyCastle Hill HospitalHullUK
  6. 6.Rosemere Cancer CentreLancashire Teaching HospitalsPrestonUK
  7. 7.Nottingham University Hospitals NHS TrustNottinghamUK
  8. 8.Bristol Haematology and Oncology CentreBristolUK

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