- 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.