Novel strategies in the treatment of castration-resistant prostate cancer             (Review).
Prostate cancer is the most common cancer in men in Europe and the United             States, and the third leading cause of death from cancer in Europe. Survival of             prostate cancer cells is dependent on the activation of androgen receptors (AR),             that are overexpressed in this tumor. Furthermore, ~90% of prostate cancer patients             that respond to first-line androgen deprivation therapy (ADT) undergo rapid progression.             This condition is defined as castration-resistant prostate cancer (CRPC). Docetaxel-based             regimens significantly improve overall survival (OS) in patients with CRPC and             represent the only treatment strategy approved by the Food and Drug Administration             (FDA). Recently, abiraterone (second hormonal therapy) and cabazitaxel (new taxane)             have been shown to improve survival in patients with CRPC who progressed following             docetaxel-based chemotherapy. Vaccine therapy has also been demonstrated to improve             OS in patients with asymptomatic or minimally symptomatic metastatic CRPC. Additional             therapeutic targets have been analyzed in prostate cancer, including apoptosis,             angiogenic receptors, vitamin D and Src pathways. Several phase II studies are             ongoing. The high frequency of prostate cancer-related metastatic bone disease             has led to consider this pathway as a therapeutic target. To this end, several             bone-targeted agents have been investigated, most notably zoledronic acid, which             is highly effective at stabilizing the bone and preventing skeletal complications.             More recently, a nuclear factor-β ligand (RANKL) inhibitor, denosumab, has been             developed for the treatment of bone metastases.
Department of Internal Medicine and Clinical Oncology, University                     of Bari Medical School, Bari, Italy.
Ilaria
I
Marech
Angelo
A
Vacca
Girolamo
G
Ranieri
Antonio
A
Gnoni
Franco
F
Dammacco
D000726:Androgen Antagonists / Q000627:therapeutic use*; D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019496:Cancer Vaccines / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D015507:Drugs, Investigational / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D058990:Molecular Targeted Therapy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D019496:Cancer Vaccines; D015507:Drugs, Investigational