title: Metastatic castration resistant prostate cancer: current strategies of management in the Middle East.
abstract: Although most patients with prostate cancer respond to initial androgen-deprivation therapy, progression to castration-resistant prostate cancer (CRPC) is almost inevitable. In 2004, the docetaxel/prednisone regimen was approved for the management of patients with metastatic CRPC, becoming the standard first-line therapy. Recent advances have also led to an unprecedented number of approved new drugs; thus, providing several treatment options for patients with metastatic CRPC. Five new drugs have received US Food and Drug Administration-approval between 2010 and 2012: sipuleucel-T, an immunotherapeutic agent; cabazitaxel, a novel microtubule inhibitor; abiraterone acetate, a new androgen biosynthesis inhibitor; enzalutamide, a novel androgen receptor inhibitor; and denosumab, a bone-targeting agent. Such drugs are either already marketed or about to be marketed in the Middle East. Data supporting the approval of each of these agents are described in this review, as are recent approaches to the treatment of metastatic CRPC.
authors.affiliation: Section of Medical Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
authors.forename: Shouki
authors.initials: S
authors.lastname: Bazarbashi
authors.affiliation: Department of Medical Oncology, El Beyrouni University Hospital, Damascus, Syria.
authors.forename: Marwan
authors.initials: M
authors.lastname: Bachour
authors.affiliation: Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Bulbul
authors.affiliation: Department of Urology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alotaibi
authors.affiliation: Department of Oncology, Tawam Hospital/Johns Hopkin Medicine, Al Ain, United Arab Emirates.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jaloudi
authors.affiliation: Department of Oncology, Tawam Hospital/Johns Hopkin Medicine, Al Ain, United Arab Emirates.
authors.forename: Hassan
authors.initials: H
authors.lastname: Jaafar
authors.affiliation: Division of Hematology & Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Deborah
authors.initials: D
authors.lastname: Mukherji
authors.affiliation: Division of Uro-Oncology, King Hussein Cancer Center, Amman, Jordan.
authors.forename: Naim
authors.initials: N
authors.lastname: Farah
authors.affiliation: Al-Amal National Hospital, Baghdad, Iraq.
authors.forename: Tahseen
authors.initials: T
authors.lastname: Alrubai
authors.affiliation: Division of Hematology & Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: as04@aub.edu.lb.
authors.forename: Ali
authors.initials: A
authors.lastname: Shamseddine
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: Abiraterone; Cabazitaxel; Castration-resistance; Denosumab; Enzalutamide; Prostate cancer; Sipuleucel-T