Ces Urol 2013, 17(3):141-153 | DOI: 10.48095/cccu2013023

New therapeutic modalities for castrate resistant prostate cancer at the beginning of 2013

Michaela Matoušková, Miroslav Hanuš

Urocentrum Praha

Pharmacotherapy of castrate resistant prostate cancer (CRPC) has undergone remarkable changes within the last several decades. A crucial discovery of hormonal dependence of prostate cancer by Huggins and Hodges, in the late 1940s, opened new therapeutic possibilities. In the 80s, the U.S. Food and Drug Administration approved the first luteinizing hormone-releasing hormone (LHRH) agonist. These drugs have a suppressive effect on the testosterone levels in the blood, which is equivalent to an orchiectomy. Nevertheless, this method has been associated with negative side effects, such as miniflares. Also, the level of testosterone in the blood was not always sufficiently low. Despite the initial therapeutic effects and good long term response, the cancer becomes hormone resistant over time. The next notable improvement in the treatment of CRPC was introduced at the beginning of this century and it included a combination of docetaxel with prednisone, as a 1st line treatment modality for CRPC. This represented a firts new therapeutic approach which prolonged the survival of patients suffering from CRPC. Within the last decade, several new molecules have been introduced, referred to as biological drugs. These are nonsteroideal antiandrogens, such as en-zalutamid, selective CYP 17 inhibitor abirateron acetate, 2nd generation taxan, cabazitaxel, and Sipuleucel T which represents a new agent active in cancer immunotherapy. Several phase II and III studies are currently ongoing to test additional new drugs, which are showing a promising effect. New drugs modulating the metabolism of bones in metastatic CRPC became available as well.

Keywords: castrate resistant prostate cancer (CRPC), hormonal therapy chemotherapy, targeted therapy, new drugs

Received: February 18, 2013; Accepted: March 12, 2013; Published: June 1, 2013