title: New treatment options for castrate-resistant prostate cancer: a urology perspective.
abstract: BACKGROUND
  Castrate-resistant prostate cancer (CRPC) is the most clinically advanced form of prostate cancer. Prior to 2004, treatment options for patients with CRPC were limited to palliative care with mitoxantrone. However, two phase III trials in 2004 showed improved survival with docetaxel compared with mitoxantrone in patients with metastatic CRPC. Docetaxel remains the current standard chemotherapy for CRPC.
  
  
  METHODS
  A literature review was conducted to ascertain agents recently approved or in development for CRPC as well as several treatment algorithms being developed in this patient population.
  
  
  RESULTS
  Recently, the US Food and Drug Administration (FDA) approved chemotherapy agents including cabazitaxel, a novel taxane, for the treatment of patients with metastatic CRPC who were previously treated with docetaxel-based chemotherapy. The immunotherapy sipuleucel-T and the androgen biosynthesis inhibitor, abiraterone, have also just been approved. A number of other novel agents are in clinical development for the management of CRPC.
  
  
  CONCLUSIONS
  Options for the management of CRPC are rapidly expanding. Based on improved survival with docetaxel in patients with CRPC, chemotherapy is being investigated for use earlier in the prostate cancer disease spectrum. Studies are actively evaluating chemotherapy in the neoadjuvant and adjuvant settings for patients with high risk, localized prostate cancer. A multidisciplinary approach towards patients with difficult-to-manage prostate cancer in which urologists familiarize themselves with these newer systemic agents and refer appropriate patients to oncologists may be beneficial.
authors.affiliation: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Gomella
authors.forename: Francisco
authors.initials: F
authors.lastname: Gelpi
authors.forename: William Kevin
authors.initials: WK
authors.lastname: Kelly
mesh_terms: D000736:Androstenes; D000737:Androstenols / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D006801:Humans; D008297:Male; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D043823:Taxoids / Q000627:therapeutic use; D014020:Tissue Extracts / Q000627:therapeutic use
chemical_list: D000736:Androstenes; D000737:Androstenols; D000970:Antineoplastic Agents; D043823:Taxoids; D014020:Tissue Extracts; D000077143:Docetaxel; C552428:cabazitaxel; C511774:sipuleucel-T; C089740:abiraterone