title: Novel chemotherapies in development for management of castration-resistant prostate cancer.
abstract: OBJECTIVE
  Four new therapies have been recently approved for the treatment of men with castration-resistant prostate cancer; still, more treatment options are needed. This review summarizes the data supporting a role for novel chemotherapies including epothilones and immunomodulators (IMiDs), as well as other novel agents within the new landscape of approved therapies.
  
  
  RESULTS
  Epothilones are a class of chemotherapy that target microtubule disassembly, similar to taxanes. Results from phase II studies demonstrating a positive impact on serum prostate-specific antigen for patupilone and sagopilone, current epothilones in development, along with those of ixabepilone, are comparable with historical response rates to docetaxel, the current first-line chemotherapy for castration-resistant disease. IMiDs, including lenalidamide and thalidomide, are also in active development in castration-resistant prostate cancer. A recent phase III study evaluating the combination of lenalidomide and docetaxel revealed decreased overall survival relative to docetaxel alone; however, additional trials are currently recruiting to investigate lenalidomide in various other combination regimens.
  
  
  CONCLUSIONS
  Epothilones could be efficacious as an additional therapy in patients who respond to docetaxel chemotherapy. A role for IMiDs, perhaps in combination with chemotherapy or androgen pathway inhibitors, remains to be elucidated.
authors.affiliation: Medical Scientist Training Program, Duke University Medical Center, Durham, NC 27705, USA.
authors.forename: Alok K
authors.initials: AK
authors.lastname: Tewari
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: George
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015195:Drug Design; D019008:Drug Resistance, Neoplasm; D034261:Epothilones / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods; D008297:Male; D008870:Microtubules / Q000187:drug effects; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000601:surgery; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000601:surgery; D011944:Receptors, Androgen / Q000187:drug effects / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000627:therapeutic use; D059016:Tumor Microenvironment / Q000187:drug effects
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D034261:Epothilones; D007155:Immunologic Factors; D011944:Receptors, Androgen; D050257:Tubulin Modulators