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Asian Journal of Andrology (2011) 13, 683-689; doi:10.1038/aja.2011.35; published online 23 May 2011
Current paradigms and Evolving concepts in metastatic castration-resistant prostate cancer
Sumanta Kumar Pal1 and Oliver Sartor2
1 Division of Genitourinary Malignancies, Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Los Angeles, CA, USA
2 Tulane University School of Medicine, New Orleans, LA, USA
Correspondence: Dr SK Pal, (spal@coh.org)
Received 21 January 2010; Revised 6 March 2010; Accepted 11 March 2011; Published online 23 May 2011.
| Abstract |
Until recently, docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The past year and a half has been marked by unprecedented progress in treatments for this disease. Three positive phase III clinical trials have emerged, each evaluating agents (sipuleucel-T, cabazitaxel and abiraterone) with distinct mechanisms of action. Herein, the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC. The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past. We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome. The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC.
Keywords: abiraterone; bevacizumab; cabazitaxel; castrate resistant; castration resistant; docetaxel; hormone refractory; Jevtana; Provenge; prostate cancer; sipuleucel-T |
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