Updates on therapeutic targets and agents in castrate-resistant prostate cancer

Czech version

Authors: M. O. Bishr; J.-B. Lattouf; P. O. Gannon; F. Saad
Authors‘ workplace: University of Montreal Hospital Center, 1560 Sherbrooke east, Montreal, Canada
Published in: Urol List 2012; 10(2): 15-23

Overview

Prostate cancer (PCa) is the most commonly diagnosed noncutaneous cancer in men and the second to third most common cause of cancer death in the western world. Nearly all patients with metastatic disease will eventually experience disease progression despite castration with a median duration of response of 18–24 months; development of castration-resistant prostate cancer (CRPC) is only a matter of time. CRPC is defined by disease progression despite androgen-deprivation therapy. CRPC presents a spectrum of disease ranging from rising PSA levels to metastases and significant debilitation from cancer symptoms. Prognosis is associated with several factors, including performance status, presence of bone pain, extent of disease on bone scan, and serum levels of alkaline phosphatase. Based on our enhanced understanding of tumor biology, including the role of tumor, host, and hormonal signaling, there has been rational development of new therapies for CRPC. Over the last decade, several clinical trials have been launched to study novel agents targeting different mechanisms of PCa progression that has been culminated by success of four new agents for CRPC (cabazitaxel, sipuleucel-T, denosumab, and abiraterone acetate) and several more molecules are on the horizon. The purpose of this review is to discuss the new therapeutic targets in CRPC focusing on new promising agents.

Key words:
prostate cancer, castrate-resistance prostate cancer, bone metastasis, androgen receptor, chemotherapy, immunotherapy, angiogenesis

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