Abstract
The development of castration resistance is an inevitable pathway for the vast majority of patients with advanced prostate cancer. Recently, there have been significant breakthroughs in the understanding and management options of castration-resistant prostate cancer. Three novel hormonal agents showed survival benefits in non-metastatic patients. As for metastatic disease, there was an even wider range of management options being investigated. This review summarized advances in the management of castration-resistant prostate cancer (CRPC) including emerging data on novel imaging techniques and treatment strategies.
Highlights
Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth leading cause of cancer mortality among men worldwide [1]
A prospective trial demonstrated that 20–40% of circulating tumor cells in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and enzalutamide had an active androgen receptors (AR) splice variant 7 (AR-V7), which was significantly associated with a lower PSA response rate and shorter progression-free survival (PFS) and overall survival (OS) compared to men without AR-V7 expression [35]
The ALSYMPCA study randomized over 900 mCRPC patients with two or more bone metastases, and no known visceral metastasis, receiving either radium-223 or the standard of care
Summary
Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth leading cause of cancer mortality among men worldwide [1]. Despite the initial success of the androgen deprivation therapy (ADT) for advanced PCa, virtually all patients eventually develop biochemical and clinical evidence of treatment resistance. This disease status is known as castration-resistant prostate cancer (CRPC). Research in genetics and cellular and molecular biology led to a better understanding of the mechanisms of castration resistance. Clinical investigators improved on diagnostic technology for metastatic diseases, and established several categories of CRPC treatments: chemotherapy, novel hormonal agents, immuno-and-targeted therapy, and theranostics
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