Evolving standards in the treatment of docetaxel-refractory castration-resistant prostate cancer

Prostate Cancer Prostatic Dis. 2011 Sep;14(3):192-205. doi: 10.1038/pcan.2011.23. Epub 2011 May 17.

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Docetaxel
  • Drug Resistance, Neoplasm
  • Humans
  • Immunotherapy
  • Male
  • Orchiectomy
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / surgery*
  • Randomized Controlled Trials as Topic
  • Receptors, Androgen / metabolism
  • Standard of Care*
  • Taxoids / pharmacokinetics
  • Taxoids / therapeutic use*
  • Treatment Failure
  • Tumor Microenvironment

Substances

  • Antineoplastic Agents
  • Receptors, Androgen
  • Taxoids
  • Docetaxel