Abiraterone or Enzalutamide in CRPC After Chemotherapy
Most prostate cancer patients treated with androgen deprivation therapy (ADT) as systemic therapy will develop castration-resistant prostate cancer (CRPC). CRPC is most frequently characterized by a rise in serum prostate-specific antigen (PSA) levels over time in the context of low (< 50 ng/mL) serum testosterone levels. Expression of PSA is typically regulated by the androgen receptor (AR), supporting a role for AR in CRPC. The biological significance of CRPC is that an important mechanism of CRPC is the upregulation of intracellular androgen and/or androgen receptor (AR), leading to sustained AR-directed growth of prostate cancer despite a castrate level of serum androgens . Thus, patients with CRPC are usually sensitive to sequential “secondary” hormonal therapies directed at AR inhibition. The treatment landscape for CRPC has expanded in the past decade to include several novel agents. These novel therapies have been directed specifically against CRPC, including abiraterone acetate (AA) and enzalutamide [2, 3]. The recent US Food and Drug Administration (FDA)-approved enzalutamide (Xtandi) and abiraterone (Xytiga) based on researches showed improvement of survival in the treatment for CRPC after chemotherapy. The present article reviews recent advances of the novel AR-targeted therapeutic agents for CRPC.
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