title: Contemporary management of metastatic castration-resistant prostate cancer.
abstract: OBJECTIVE
  This review will describe the contemporary management of castration-resistant prostate cancer in the context of multiple recent advances.
  
  
  RESULTS
  Two novel agents have been added to the therapeutic armamentarium including cabazitaxel and sipuleucel-T. Cabazitaxel, a novel taxane extended survival in men with progressive metastatic CRPC following conventional docetaxel-based chemotherapy. Sipuleucel-T, an autologous dendritic cell based vaccine extended survival in men with relatively asymptomatic metastatic CRPC without visceral metastasis. A third agent, abiraterone acetate, an orally administered CYP17 inhibitor, which suppresses androgen synthesis has been preliminarily reported to significantly prolong survival following prior docetaxel and approval by regulatory agencies is anticipated. Baseline and early changes in circulating tumor cells appear useful as a prognostic factor. Additionally, data demonstrated the superiority of denosumab, a RANK-ligand antagonist, compared to zoledronic acid in the prevention of skeletal related events in men with bone metastases.
  
  
  CONCLUSIONS
  Cabazitaxel, sipuleucel-T and denosumab were approved in 2010 by regulatory agencies in the USA for men with metastatic CRPC, and approval of abiraterone acetate is anticipated based on the results of a phase III trial. The evaluation of circulating tumor cells assists in determining prognosis, although its utility for clinical decision-making entails validation.
authors: Texas Oncology,Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas, USA.
authors: Guru
authors: G
authors: Sonpavde
authors: Cora N
authors: CN
authors: Sternberg
mesh_terms: D000736:Androstenes; D000737:Androstenols / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D002369:Castration; D000069448:Denosumab; D004358:Drug Therapy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*; D053245:RANK Ligand / Q000627:therapeutic use; D043823:Taxoids / Q000627:therapeutic use; D013736:Testicular Neoplasms / Q000556:secondary* / Q000628:therapy*; D014020:Tissue Extracts / Q000627:therapeutic use
chemical_list: D000736:Androstenes; D000737:Androstenols; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053245:RANK Ligand; D043823:Taxoids; D014020:Tissue Extracts; D000069448:Denosumab; C552428:cabazitaxel; C511774:sipuleucel-T; C089740:abiraterone