[How to manage patients with CRPC?].
- Authors
- Type
- Published Article
- Journal
- Bulletin du Cancer
- Publisher
- Elsevier
- Publication Date
- Jun 01, 2015
- Volume
- 102
- Issue
- 6
- Pages
- 509–515
- Identifiers
- DOI: 10.1016/j.bulcan.2015.04.015
- PMID: 26028494
- Source
- Medline
- Keywords
- License
- Unknown
Abstract
Despite castrate levels of androgens, the androgen receptor (AR) remains active and continues to drive prostate cancer progression. Since the approval of docetaxel, four additional agents that show a survival benefit have been registered on the basis of randomized phase 3 trials. These have included enzalutamide and abiraterone, two agents designed specifically to affect the androgen axis, sipuleucel-T, which stimulates the immune system and cabazitaxel, a chemotherapeutic agent. Denosumab was shown to significantly delay skeletal-related events. Clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision making more complex. The induction of constitutively-active AR splice variants (AR-Vs) driving clonal proliferation of AR-negative and AR-independent metastases may be one major potential mechanism of resistance to new hormone therapies.