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Abstract

Volume 15, Issue 3 (May 2013) 15, 342–349; 10.1038/aja.2013.38

Evolving landscape and novel treatments in metastatic castrate-resistant prostate cancer

Paul J Toren and Martin E Gleave

Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada

Correspondence: Professor ME Gleave, (m.gleave@ubc.ca)

Received 30 January 2013; Revised 22 February 2013; Accepted 23 February 2013 Advance online publication 15 April 2013

Abstract

Treatment options for castrate-resistant prostate cancer (CRPC) have advanced in recent years and significantly improved the outlook for patients with this aggressive and lethal disease. Further understanding of the biology of CRPC has led to several new targeted therapies and continues to emphasize the importance of androgen receptor (AR) directed therapy. The treatment landscape is rapidly changing and further biologically rationale, biomarker-based ongoing clinical trials are needed. We review the recent results of major clinical trials in CRPC. New and investigational agents now in clinical evaluation are reviewed including inhibitors of angiogenesis, microtubules, chaperones, AR and intracellular kinases, as well as immunotherapy, radiopharmaceuticals and bone-targeted agents. The recent improvement in prognosis for CRPC brings continued optimism for further improvements. Thoughtful planning of clinical trials and further understanding of the mechanisms of resistance to therapies will allow for continued progress in patient care.


Keywords:prostate cancer; treatment resistance; androgen receptor antagonists; molecular targets

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