Novel therapeutic approaches to advanced prostate cancer.
Considerable progress in the treatment of advanced prostate cancer was made in 2004 with the approval by the US Food and Drug Administration of docetaxel for the treatment of metastatic hormone-refractory prostate cancer. The survival benefit with docetaxel and prednisone, however, has been modest, on the order of 2-3 months compared with mitoxantrone and prednisone. While docetaxel-based therapy has demonstrated improvement in symptomatic and quality-of-life endpoints, certainly there is a pressing need for improvement in outcomes. A number of novel agents are in basic and clinical development for advanced prostate cancer, some of which are specific to mechanisms that may be important in the development and spread of prostate cancer. Novel approaches including immunotherapy, antiangiogenic compounds, and cell growth and survival pathway inhibitors, as well as targeted cytotoxic compounds, are among the broad categories that will be discussed in this review. Clinical advances in meaningful endpoints such as survival and quality of life are eagerly awaited in large-scale trials of active and rationally designed agents.
Armstrong
Andrew J
AJ
Johns Hopkins School of Medicine, Baltimore, MD 21231, USA.
Carducci
Michael A
MA
D000230:Adenocarcinoma / Q000098:blood supply / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D019496:Cancer Vaccines / Q000627:therapeutic use; D002454:Cell Differentiation / Q000187:drug effects; D002455:Cell Division / Q000187:drug effects; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D019468:Disease Management; D000077143:Docetaxel; D016503:Drug Delivery Systems; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D008297:Male; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D011471:Prostatic Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D015398:Signal Transduction / Q000187:drug effects; D043823:Taxoids / Q000008:administration & dosage
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D004791:Enzyme Inhibitors; D009363:Neoplasm Proteins; D043823:Taxoids; D000077143:Docetaxel