Abstract
The management of men with metastatic castration-resistant prostate cancer (CRPC) has taken several leaps forward in the past year, with the demonstration of improved overall survival with three novel agents (sipuleucel-T, cabazitaxel with prednisone and abiraterone acetate with prednisone), and a significant delay in skeletal-related events observed with denosumab. The pipeline of systemic therapies in prostate cancer remains strong, as multiple agents with a diverse array of mechanisms of action are showing preliminary signs of clinical benefit, leading to more definitive phase III confirmatory trials. In this review, which represents part 1 of a two-part series on metastatic CRPC, we will summarize the mechanisms of resistance to hormonal and chemotherapies and discuss the evolving landscape of treatment options for men with CRPC, with a particular focus on currently approved and emerging treatment options following docetaxel administration, as well as prognostic factors in this post-docetaxel state. As docetaxel remains the standard initial systemic therapy for men with metastatic CRPC for both palliative and life-prolonging purposes, knowledge of these evolving standards will help to optimize delivery of care and long-term outcomes.
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Dr Antonarakis declares no conflicts of interest. Dr Armstrong has served as a consultant for Novartis and Amgen; he is on the speaker's bureau for Pfizer, sanofi-aventis and Dendreon; and he has received research funding from Bristol-Myers Squibb, Imclone, Pfizer/Wyeth, Active Biotech, Medivation, Dendreon, Novartis and sanofi-aventis.
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Antonarakis, E., Armstrong, A. Evolving standards in the treatment of docetaxel-refractory castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 14, 192–205 (2011). https://doi.org/10.1038/pcan.2011.23
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DOI: https://doi.org/10.1038/pcan.2011.23
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