Landmarks in non-hormonal pharmacological therapies for castration-resistant prostate cancer

Authors

  • Noel W. Clarke

    Corresponding author
    1. The Christie and Salford Royal Hospitals, Manchester, UK
      Professor Noel W. Clarke, Department of Surgery, The Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK. e-mail: noel.clarke@christie.nhs.uk
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Professor Noel W. Clarke, Department of Surgery, The Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK. e-mail: noel.clarke@christie.nhs.uk

Abstract

  • • The treatment of metastatic and castration-resistant prostate cancer (CRPC) has advanced considerably from the era where it was considered that the disease was resistant to chemotherapy.
  • • Cytotoxic chemotherapy involving docetaxel is now used routinely as a first-line therapy after failed first- and second-line androgen deprivation in advanced disease, improving quality of life and to a limited extent, survival in patients with advanced prostate cancer.
  • • The cytotoxic taxane, cabazitaxel has also become a second-line treatment option for patients with CRPC failing previous docetaxel therapy.
  • • Additionally, a broad range of agents are now available or under development including immune-based therapies (cellular therapies and vaccines), bone-targeting agents (anti-osteolytic and anti-tumour therapies) and molecular-based agents targeting cellular control mechanisms.
  • • Most of these remain experimental but on-going pharmacological development will inevitably provide urologists and urological oncologists with a broader range of therapeutic options for better cancer management in the future.

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