Tuesday, September 17, 2013

Current, New and Novel Therapy for Castration-Resistant Prostate Cancer part 1


Key Issues

  • Although hormonal therapy is highly effective for the control of cancer-related symptoms, all men who live long enough will eventually experience disease progression and develop castration-resistant prostate cancer (CRPC).
  • CRPC remains an extremely heterogeneous disease with few surrogate end points other than overall survival upon which drug development has been based.
  • Androgen signaling continues to play a critical role in prostate cancer progression following castration.
  • Advances in the understanding of the molecular mechanisms underlying CRPC has translated into a variety of treatment approaches.
  • The number of treatment options for men with metastatic CRPC has increased over the last 2 years with US FDA approval of sipuleucel-T, cabazitaxel, abiraterone and MD-3100.
  • New agents as TAK-700 and ipilimumab with early promising results are in advanced clinical trials and have the potential to provide novel treatments options for CRPC in the near future.
  • Denosumab was approved by FDA in July 2011 for patients with bone metastases from solid tumors after demonstrating its superiority against zoledronic acid to prevent skeletal-related events.
  • Standardization of clinical parameters (quality-of-life changes, pain responses), new imaging test (functional imaging) and finding of biomarkers are necessary to compare and evaluate response to the different drugs.
  • New data supporting the role of novel molecular targets is promoting new clinical trials with new drugs.

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