Castration Resistant Prostate Cancer: Current Treatments and Future Prospects

REVIEW ARTICLE

Emre Can Akinsal and Mustafa Sofikerim

Affiliation: Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey

ABSTRACT

Prostate cancer is the most frequently diagnosed cancer and the second leading cause of cancer death in men in the United States. Unfortunately, most of these patients will fail and inevitably progress to hormone-independent disease. Prostate cancer that progresses in the presence of androgen blockade is defined as castration resistant prostate cancer (CRPC). No effective "standard" chemotherapy exists for these patients, in which median survival is 6-9 months.

Treatment options for CRPC are secondary hormonal manipulations, immunotherapy, chemotherapy, inhibition of invasion and metastases, inhibition and/or blockade of growth factor receptors or growth factor receptor pathways, inhibition of neoangiogenesis, and supportive care.

Docetaxel and prednisone are the first-line therapies for CRPC and they prolong overall survival. Although many clinical studies have been done, currently there is still no effective second-line treatment modality for CRPC. Better understanding of the mechanisms of drug resistance, discovery of new agents, and targeting of new pathways in the emergence of CRPC would ultimately lead to a better chance of survival with the use of standard and evolving combination therapies.

Keywords: prostate cancer, castration resistant, chemotherapy, treatment

Correspondence: Mustafa Sofikerim, Department of Urology, Faculty of Medicine, Erciyes University, 38030 Kayseri, Turkey. Tel: +90 352 4374937 21455; Fax: +90 0352 4377613; e-mail: mustafasofikerim@yahoo.com