New perspectives in the therapy of castration resistant prostate cancer

Abstract

Prostate Cancer is the most commonly diagnosed malignancy and the second leading cause of cancer-related death in men in the Western World. Docetaxel-based chemotherapy has been the mainstay of treatment until a few years ago for metastatic castration resistant prostatic cancer (mCRPC). Recently, a broad range of therapeutic options has become available for mCRPC in a variety of settings, including chemotherapeutic agents (cabazitaxel), androgen synthesis inhibitors (abiraterone acetate), androgen receptor (AR) inhibitors (enzalutamide) and immunotherapy (sipuleucel-T). Multiple novel targeted agents are at an advanced stage of experimentation, including androgen synthesis inhibitors (TAK700), AR inhibitors (ARN509), radiopharmaceuticals (radium-223) and immunotherapeutic agents (poxvirus-based vaccine, ipilimumab). This review describes in detail the latest results obtained with a the most promising agents in prostate cancer, with a focus on CRPC biology and mechanism of resistance to anti-neoplastic treatment.