Abstract
Background: Prostate cancer is one of the most common cancer threats to men. The incidence rate and mortality rate are second only to lung cancer in Europe and America. At present, the 5-year survival rate of prostate cancer is only 29% when metastasis occurs. Prostate cancer seriously endangers the health of male patients. Early prostate cancer surgery and radiotherapy and chemotherapy effect is better, advanced endocrine therapy effect is better, because of drug resistance, eventually progress to castration resistant prostate cancer (CRPC). Although new drugs such as abiraterone acetate, enzalutamide, apalutamide and darutamide have brought new hope to patients with CRPC, when CRPC progresses to metastatic castration resistant prostate cancer (mCRPC), the effect of endocrine therapy is limited. Objective: Immunotherapy, immunosuppressive checkpoint inhibitors and molecular targeted therapy bring new hope to patients with CRPC. This article will review the new progress of immunotherapy and molecular targeted therapy. Methods: A number of clinical and experimental studies were reviewed to indicate the novel advancement in the progressive therapy of CRPC. Results: Immunotherapy, immunosuppressive checkpoint inhibitors and molecular targeted therapy can improve median survival time and have a decrease of PSA level. Conclusion: With the advancements in CRPC therapy made by the researchers, some novel potential methods will occupy more and more important position in the treatment of CRPC.
Highlights
Prostate cancer remains the second most common cause of cancer death in the United States [1]
This review will focus on two new and developing therapeutic areas that have the potential to revolutionize the management of metastatic castration resistant prostate cancer (mCRPC): immunotherapy, immunocheckpoint inhibitors, and poly ADP ribose polymerase (PARP) inhibitors targeted therapy
PARP inhibitors lead to cancer cell death through "synthetic lethality", that is, the combination of PARP inhibition and homologous recombination gene mutation in tumor may lead to the loss of compensatory DNA repair mechanism, leading to cancer cell death due to irreparable DNA damage [16]
Summary
Prostate cancer remains the second most common cause of cancer death in the United States [1]. It is estimated that about 31000 men died this year from metastatic castrated prostate cancer (mCRPC), a deadly form of the disease [1]. Since the approval of radium-223 in 2013, no new treatment has been approved in this field; there has been significant progress and expansion in the treatment category for mcrpc. This review will focus on two new and developing therapeutic areas that have the potential to revolutionize the management of mCRPC: immunotherapy, immunocheckpoint inhibitors, and poly ADP ribose polymerase (PARP) inhibitors targeted therapy. Immunotherapy and the use of PARP inhibitors may change the future prospects and prognosis of mCRPC patients [2, 3]
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