What's New in Hormone-refractory Prostate Cancer Treatment

Abstract

Prostate cancer represents the most common cancer in men in US and the fifth in men in Korea. For the patients with advanced prostate cancer, androgen deprivation therapy (ADT) remains the gold standard. However, patients with metastatic prostate cancer treated with ADT frequently develop hormone-refractory status (HRPC). Recent large randomized clinical trials demonstrated that docetaxel-based chemotherapy enhance survival and improve the quality of life in patients with HRPC. Although docetaxel-based chemotherapy has become the standard treatment for HRPC, PSA responses rarely exceed 50% and median survival is still less than 2 years. Therefore, there is a need for newer agents that can improve outcomes. This review focuses on the current therapies for the treatment of HRPC, including new cytotoxic agents, antiproliferative agents, antitumor vaccine and antiangiogenic agents. These approaches yielded expected or disappointing results in the phase II or III trials. Interpretation of these trials is sometimes complicated by discordant radiographic and PSA responses. Further investigation in search of more predictive new markers is warranted. Docetaxel-based chemotherapy has become the first-line standard treatment for HRPC, but the survival results are not satisfactory. Therefore, newer agents are being developed with promising results in phase II trials. These new agents should demonstrate higher patient survival rate in phase III studies on a larger scale in order to be approved for clinical use.