title: Evolving landscape and novel treatments in metastatic castrate-resistant prostate cancer.
abstract: Treatment options for castrate-resistant prostate cancer (CRPC) have advanced in recent years and significantly improved the outlook for patients with this aggressive and lethal disease. Further understanding of the biology of CRPC has led to several new targeted therapies and continues to emphasize the importance of androgen receptor (AR) directed therapy. The treatment landscape is rapidly changing and further biologically rationale, biomarker-based ongoing clinical trials are needed. We review the recent results of major clinical trials in CRPC. New and investigational agents now in clinical evaluation are reviewed including inhibitors of angiogenesis, microtubules, chaperones, AR and intracellular kinases, as well as immunotherapy, radiopharmaceuticals and bone-targeted agents. The recent improvement in prognosis for CRPC brings continued optimism for further improvements. Thoughtful planning of clinical trials and further understanding of the mechanisms of resistance to therapies will allow for continued progress in patient care.
authors.affiliation: Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Toren
authors.forename: Martin E
authors.initials: ME
authors.lastname: Gleave
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D059002:Androgen Receptor Antagonists / Q000627:therapeutic use; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D008297:Male; D018832:Molecular Chaperones / Q000037:antagonists & inhibitors; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000628:therapy; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D050257:Tubulin Modulators / Q000627:therapeutic use
chemical_list: D000726:Androgen Antagonists; D059002:Androgen Receptor Antagonists; D020533:Angiogenesis Inhibitors; D050071:Bone Density Conservation Agents; D018832:Molecular Chaperones; D047428:Protein Kinase Inhibitors; D019275:Radiopharmaceuticals; D050257:Tubulin Modulators