PURPOSE OF REVIEW: Four new therapies have been recently approved for the treatment of men with castration-resistant prostate cancer; still, more treatment options are needed.
This review summarizes the data supporting a role for novel chemotherapies including epothilones and immunomodulators (IMiDs), as well as other novel agents within the new landscape of approved therapies.
RECENT FINDINGS: Epothilones are a class of chemotherapy that target microtubule disassembly, similar to taxanes. Results from phase II studies demonstrating a positive impact on serum prostate-specific antigen for patupilone and sagopilone, current epothilones in development, along with those of ixabepilone, are comparable with historical response rates to docetaxel, the current first-line chemotherapy for castration-resistant disease. IMiDs, including lenalidamide and thalidomide, are also in active development in castration-resistant prostate cancer. A recent phase III study evaluating the combination of lenalidomide and docetaxel revealed decreased overall survival relative to docetaxel alone; however, additional trials are currently recruiting to investigate lenalidomide in various other combination regimens.
SUMMARY: Epothilones could be efficacious as an additional therapy in patients who respond to docetaxel chemotherapy. A role for IMiDs, perhaps in combination with chemotherapy or androgen pathway inhibitors, remains to be elucidated.
Written by:
Tewari AK, George DJ. Are you the author?
Medical Scientist Training Program bDivisions of Medical Oncology and Urology, Duke University Medical Center, Durham, North Carolina, USA.
Reference: Curr Opin Urol. 2013 May;23(3):220-9.
doi: 10.1097/MOU.0b013e32835f7da2
PubMed Abstract
PMID: 23511791
