Korean J Urol.  2011 Mar;52(3):157-165.

Current Treatment Strategies for Castration-Resistant Prostate Cancer

• Kim SJ
• Kim SI

Abstract

Prostate cancer is the most common cancer in men in United States and the fifth most common cancer in men in Korea. Although the majority of patients with metastatic prostate cancer initially respond to androgen deprivation therapy, almost all patients will eventually progress to develop castration-resistant prostate cancer (CRPC). Treatment options for CRPC remain limited. Prostate cancer was considered unresponsive to chemotherapy until the mid-1990s, when mitoxantrone combined with prednisone was shown to play a role in the palliative treatment of patients with CRPC. In 2004, two large randomized clinical trials demonstrated for the first time a small but significant survival advantage of docetaxel-based chemotherapy compared with mitoxantrone in patients with metastatic CRPC. Recently, cabazitaxel was shown to improve survival in patients with metastatic CRPC who progressed after docetaxel-based chemotherapy. Sipuleucel-T was also demonstrated to improve overall survival in patients with asymptomatic or minimally symptomatic metastatic CRPC. Along with mitoxantrone and docetaxel, cabazitaxel and sipuleucel-T are now approved for use in metastatic CRPC by the US Food and Drug Administration. There have been multiple early-phase clinical trials of various agents for the treatment of CRPC, and some are in phase III development. This review focuses on the key clinical trials of various treatment options of CRPC currently in use and under investigation.

Keyword

Drug therapy; Immunotherapy; Molecular targeted therapy; Prostatic neoplasms; Survival

MeSH Terms

Humans
Imidazoles
Immunotherapy
Korea
Male
Mitoxantrone
Molecular Targeted Therapy
Nitro Compounds
Palliative Care
Prednisone
Prostate
Prostatic Neoplasms
Taxoids
Tissue Extracts
United States
United States Food and Drug Administration
Imidazoles
Mitoxantrone
Nitro Compounds
Prednisone
Taxoids
Tissue Extracts

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