Castration-Resistant Prostate Cancer: Current Status and Future Directions

REVIEW ARTICLE

Saadettin Eskicorapci, Ali Ersin Zumrutbas, Tahir Turan and Omer Levent Tuncay

Affiliation: Department of Urology, Pamukkale University Medical School, Denizli, Turkey

ABSTRACT

Over the past decade, the treatment alternatives of castration-resistant prostate cancer (CRPC) have developed significantly, especially with the revelation of the docetaxel-based chemotherapy regimes. However, despite several attempts, the median survival for men with metastatic CRPC remains as 1–2 years. The purpose of this article is to discuss the current status and recent developments in the field of CRPC, focusing particularly on the new agents that are most encouraging. Nonetheless, there are serious improvements being made in the development of more effective antiandrogens and cytochrome P17 inhibitors (abiraterone, MDV3100), novel chemotherapy regimens, targeted therapies, and immunotherapies (sipuleucel-T). For the most part, new therapeutic agents are being combined with chemotherapy, similar to the approach taken in other tumors. However, the development of new approaches to the treatment of castration resistant prostate cancer presents many challenges that will demand collaboration and consensus building with respect to biomarkers for patient selection, clinical endpoints, and trial designs.

Keywords: castration-resistant prostate cancer, chemotherapy, immunotherapy, hormonal therapy, targeted therapeutics, vascular endothelial growth factor, androgens

Correspondence: Saadettin Eskicorapci, Department of Urology, Pamukkale University Medical School, Denizli, Turkey. Tel: +90 258 444 0 728; Fax: 0090 2582134922; e-mail: drsye@yahoo.com