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J Clin Outcomes Manage
2012 Jan;19(1):38-47
Treatment of castration-resistant prostate cancer
Elfiky A
Abstract Objective: To review therapeutics for castration-resistant prostate cancer (CRPC).Methods: Literature review. Results: Targeting of androgen-dependent pathways in CRPC post-chemotherapy has been shown to improve survival with the lyase inhibitor abiraterone and lead to PSA and objective responses with an androgen receptor antagonist (MDV3100). However, the addition of bevacizumab to docetaxel/prednisone in treating metastatic CRPC failed to provide a survival benefit. Cabazitaxel in metastatic CRPC post-docetaxel did demonstrate a survival benefit. Provenge, an autologous dendritic cell-based vaccine, demonstrated a reduction in the risk of death in metastatic CRPC. Other immunotherapy agents, including Prostvac and ipilumumab, are under investigation. We also discuss the receptor tyrosine kinase inhibitor XL184 and poly (ADP-ribose) polymerase inhibitors which are in early clinical trials. Conclusion: Recent advances in androgen targeting, chemotherapy, immunotherapy, and other targeted therapies have led to significant improvements in the care of CRPC patients.
Case-Based Review
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