title: Role of second-line systemic treatment post-docetaxel in metastatic castrate resistant prostate cancer- current strategies and future directions.
abstract: Treatment of metastatic castrate resistant prostate cancer (mCRPC) after progression on docetaxel chemotherapy is a challenging clinical scenario with limited availability of treatment options. Re-treatment with docetaxel, either as monotherapy or in combination with other cytotoxics or targeted agents has shown durable responses. However, most docetaxel re-treatment studies have been either retrospective or early phase non-randomised studies which have not formally assessed Quality of life or survival gain with re-treatment. Despite limited evidence for efficacy of mitoxantrone in the second-line, it continues to remain widely used, largely due to lack of available suitable alternatives. Cabazitaxel in combination with prednisolone is the only chemotherapy to have shown a significant survival benefit and receive approval by the U.S. Food and Drug Administration for patients with mCRPC previously treated with a docetaxel-based regimen. Abiraterone acetate has recently demonstrated a significant improvement in survival when compared to placebo in patients with docetaxel-treated mCRPC. This review aims to summarize the current evidence and discuss future strategies for treatment of mCRPC patients following failure of docetaxel chemotherapy.
authors.affiliation: Consultant in Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK. drjawaher@yahoo.com
authors.forename: Jawaher
authors.initials: J
authors.lastname: Ansari
authors.forename: Syed A
authors.initials: SA
authors.lastname: Hussain
authors.forename: Abdulla
authors.initials: A
authors.lastname: Alhasso
authors.forename: Rana
authors.initials: R
authors.lastname: Mahmood
authors.forename: Asif
authors.initials: A
authors.lastname: Ansari
authors.forename: John
authors.initials: J
authors.lastname: Glaholm
mesh_terms: D000736:Androstenes; D000737:Androstenols / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D018572:Disease-Free Survival; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D005544:Forecasting; D006801:Humans; D008297:Male; D008942:Mitoxantrone / Q000008:administration & dosage / Q000627:therapeutic use; D009362:Neoplasm Metastasis; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011788:Quality of Life; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D000736:Androstenes; D000737:Androstenols; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; C552428:cabazitaxel; D011239:Prednisolone; D008942:Mitoxantrone; C089740:abiraterone