title: Systemic therapy after first-line docetaxel in metastatic castration-resistant prostate cancer.
abstract: OBJECTIVE
  There is an urgent need for systemic treatment options for patients with castration-resistant prostate cancer who have progressed after receiving first-line docetaxel chemotherapy. The purpose of this article is to review recent developments in this area.
  
  
  RESULTS
  Retreatment with docetaxel has been employed with evidence of activity in selected populations. Mitoxantrone, the previous first-line standard based on its palliative effect, has also been used with clinical responses observed; however, the symptom benefit in this setting has not been established. Several classes of cytotoxic agents have been tested including platinum agents (satraplatin), epothilones (ixabepilone and patupilone) and taxanes (XRP-6258). A number of targeted therapies have also been clinically evaluated including inhibitors of cytoprotective chaperones (OGX-011) and the vascular endothelial growth factor receptor (sorafenib, sunitinib, and cediranib). An area generating great interest has been the development of agents that target the androgen receptor axis more effectively (MDV3100 and abiraterone) with encouraging early phase trial results.
  
  
  CONCLUSIONS
  There is no accepted standard systemic treatment for patients with castration resistant prostate cancer and progressive disease after docetaxel. Novel agents are in phase II and III clinical testing in this setting.
authors.affiliation: BC Cancer Agency, Vancouver, Canada.
authors.forename: Emma K
authors.initials: EK
authors.lastname: Beardsley
authors.forename: Kim N
authors.initials: KN
authors.lastname: Chi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D000077143:Docetaxel; D034261:Epothilones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008942:Mitoxantrone / Q000627:therapeutic use; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood; D013873:Thionucleotides / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D034261:Epothilones; C503781:OGX-011; D009944:Organoplatinum Compounds; D043823:Taxoids; D013873:Thionucleotides; D000077143:Docetaxel; D013739:Testosterone; C081294:satraplatin; D008942:Mitoxantrone; D040262:Receptors, Vascular Endothelial Growth Factor