Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review
The introduction of novel therapeutic agents for advanced prostate cancer has led to a wide range of treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC). In the past decade, new treatment options for mCRPC, including abiraterone, enzalutamide, docetaxel, cab...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Korean Society for Sexual Medicine and Andrology
2023-10-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| _version_ | 1797686691047145472 |
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| author | Koji Hatano Norio Nonomura |
| author_facet | Koji Hatano Norio Nonomura |
| author_sort | Koji Hatano |
| collection | DOAJ |
| description | The introduction of novel therapeutic agents for advanced prostate cancer has led to a wide range of treatment options for
patients with metastatic castration-resistant prostate cancer (mCRPC). In the past decade, new treatment options for mCRPC,
including abiraterone, enzalutamide, docetaxel, cabazitaxel, sipuleucel-T, radium-223, 177Lu-PSMA-617, and Olaparib, have
demonstrated a survival benefit in phase 3 trials. Bone-modifying agents have become part of the overall treatment strategy
for mCRPC, in which denosumab and zoledronic acid reduce skeletal-related events. Recently, androgen receptor-signaling
inhibitors (ARSIs) and docetaxel have been used upfront against metastatic castration-sensitive prostate cancer. Further, triplet
therapy with ARSI, docetaxel, and androgen deprivation therapy is emerging. However, cross-resistance may occur between
these treatments, and the optimal treatment sequence must be considered. The sequential administration of ARSIs, such as
abiraterone and enzalutamide, is associated with limited efficacy; however, cabazitaxel is effective for patients with mCRPC
who were previously treated with docetaxel and had disease progression during treatment with ARSI. Radioligand therapy
with 177Lu-PSMA-617 is a new effective class of therapy for patients with advanced PSMA-positive mCRPC. Tumors with
gene alterations that affect homologous recombination repair, such as BRCA1 and BRCA2 alterations, are sensitive to poly
(adenosine diphosphate–ribose) polymerase (PARP) inhibitors in mCRPC. This review sought to highlight recent advances in
systemic therapy for mCRPC and strategies to support patient selection and treatment sequencing. |
| first_indexed | 2024-03-12T01:09:29Z |
| format | Article |
| id | doaj.art-184a8ab8bc87471895d9cf82ca708403 |
| institution | Directory Open Access Journal |
| issn | 2287-4208 2287-4690 |
| language | English |
| last_indexed | 2024-03-12T01:09:29Z |
| publishDate | 2023-10-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj.art-184a8ab8bc87471895d9cf82ca7084032023-09-14T06:38:23ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902023-10-0141476978410.5534/wjmh.220200Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated ReviewKoji Hatano0https://orcid.org/0000-0002-8409-5152Norio Nonomura1https://orcid.org/0000-0002-6522-6233Department of Urology, Osaka University Graduate School of Medicine, Suita, JapanDepartment of Urology, Osaka University Graduate School of Medicine, Suita, JapanThe introduction of novel therapeutic agents for advanced prostate cancer has led to a wide range of treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC). In the past decade, new treatment options for mCRPC, including abiraterone, enzalutamide, docetaxel, cabazitaxel, sipuleucel-T, radium-223, 177Lu-PSMA-617, and Olaparib, have demonstrated a survival benefit in phase 3 trials. Bone-modifying agents have become part of the overall treatment strategy for mCRPC, in which denosumab and zoledronic acid reduce skeletal-related events. Recently, androgen receptor-signaling inhibitors (ARSIs) and docetaxel have been used upfront against metastatic castration-sensitive prostate cancer. Further, triplet therapy with ARSI, docetaxel, and androgen deprivation therapy is emerging. However, cross-resistance may occur between these treatments, and the optimal treatment sequence must be considered. The sequential administration of ARSIs, such as abiraterone and enzalutamide, is associated with limited efficacy; however, cabazitaxel is effective for patients with mCRPC who were previously treated with docetaxel and had disease progression during treatment with ARSI. Radioligand therapy with 177Lu-PSMA-617 is a new effective class of therapy for patients with advanced PSMA-positive mCRPC. Tumors with gene alterations that affect homologous recombination repair, such as BRCA1 and BRCA2 alterations, are sensitive to poly (adenosine diphosphate–ribose) polymerase (PARP) inhibitors in mCRPC. This review sought to highlight recent advances in systemic therapy for mCRPC and strategies to support patient selection and treatment sequencing.androgen receptor antagonistsandrogen synthesis inhibitorschemotherapydocetaxelparp inhibitorprostate cancer |
| spellingShingle | Koji Hatano Norio Nonomura Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review The World Journal of Men's Health androgen receptor antagonists androgen synthesis inhibitors chemotherapy docetaxel parp inhibitor prostate cancer |
| title | Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review |
| title_full | Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review |
| title_fullStr | Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review |
| title_full_unstemmed | Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review |
| title_short | Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review |
| title_sort | systemic therapies for metastatic castration resistant prostate cancer an updated review |
| topic | androgen receptor antagonists androgen synthesis inhibitors chemotherapy docetaxel parp inhibitor prostate cancer |
| work_keys_str_mv | AT kojihatano systemictherapiesformetastaticcastrationresistantprostatecanceranupdatedreview AT noriononomura systemictherapiesformetastaticcastrationresistantprostatecanceranupdatedreview |