PURPOSE OF REVIEW: Prior to 2010, docetaxel was the only treatment shown to prolong survival in metastatic castrate-resistant prostate cancer (CRPC).
In the past 3 years, several therapeutic agents have demonstrated survival improvements for CRPC after the receipt of prior docetaxel, leading to multiple approvals by the US Food and Drug Administration.
RECENT FINDINGS: The development of these novel agents, each with a distinct mechanism of action, is the fruition of sedulous preclinical research and well designed clinical trials. Cabazitaxel, a next generation taxane, was the first Food and Drug Administration-approved drug for the postdocetaxel setting. The recognition of sustained androgen dependence of CRPC has led to the identification of more potent and selective inhibitors of androgen synthesis and androgen-receptor signaling, such as abiraterone and enzalutamide, respectively. Radium-223, an α-emitting radionuclide still under regulatory review, recently showed a significant survival benefit for CRPC. Finally, sipuleucel-T, a form of immunotherapy, may benefit a subset of patients in the postdocetaxel setting.
SUMMARY: Post-docetaxel management of CRPC has undergone a dramatic yet welcome paradigm change in the past 3 years. With multiple life-prolonging agents available, it now becomes imperative to coordinate how and when these new therapies should be used and sequenced to achieve optimal patient outcomes.
Written by:
Zhao S, Yu EY. Are you the author?
Fred Hutchinson Cancer Research Center and University of Washington School of Medicine; University of Washington School of Medicine, Seattle Cancer Care Alliance, Seattle, Washington, USA.
Reference: Curr Opin Urol. 2013 Jan 29. Epub ahead of print.
doi: 10.1097/MOU.0b013e32835e2253
PubMed Abstract
PMID: 23344012
