Tumor Biology

, Volume 35, Issue 8, pp 7391–7392 | Cite as

How to optimize the sequential use of novel therapeutics in metastatic prostate cancer patients? Response should be found in prostate cancer tissue

  • Edoardo Francini
  • Giandomenico Roviello
Research Commentary

Dear Editor,

To date, Food and Drug Administration (FDA) approved abiraterone acetate (AA), enzalutamide (E), and cabazitaxel (Cbz) as new options for patients with castration-resistant prostate cancer (CRPC) whose disease progresses during or after docetaxel (D) treatment. However, little data are available about optimal sequencing for these agents. Recently, Schrader et al. [1] described the effects of E after AA failure. Their data showed that E is only moderately effective and suggested that cross-resistance between AA and E was a common phenomenon. Conversely, Pezaro et al. demonstrate significant Cbz activity in CRPC progressing after treatment with D and AA or E [2]. In this study, activity on Cbz appeared more modest in the cohort not treated with AA nor E, while higher antitumour activity with Cbz in AA- and E-treated patients was reported. Authors hypothesized that the constitutively activated androgen receptor (AR) splice variants, which generally could result in resistance...


Prostate Cancer Androgen Receptor Abiraterone Enzalutamide Cabazitaxel 
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Conflicts of interest



  1. 1.
    Schrader AJ, Boegemann M, Ohlmann CH, Schnoeller TJ, Krabbe LM, Hajili T, et al. Enzalutamide in castration-resistant prostate cancer patients progressing after docetaxel and abiraterone. Eur Urol. 2013;65:30–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Pezaro CJ, Omlin AG, Altavilla A, Lorente D, Ferraldeschi R, Bianchini D, et al. Activity of cabazitaxel in castration-resistant prostate cancer progressing after docetaxel and next-generation endocrine agents. Eur Urol. 2013. doi: 10.1016/j.eururo.2013.11.044.Google Scholar
  3. 3.
    Sun Y, Niu J, Huang J. Neuroendocrine differentiation in prostate cancer. Am J Transl Res. 2009;1:148–62.PubMedCentralPubMedGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  1. 1.Medical Oncology Unit, Policlinico Umberto I HospitalUniversity of RomeRomeItaly
  2. 2.Medical Oncology UnitUniversity of SienaSienaItaly

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