title: Therapeutic opportunities for castration-resistant prostate cancer patients with bone metastases.
abstract: Patients with castration-resistant prostate cancer are burdened not only with an unavoidable risk of mortality but also by severe mobility issues. This disease has a high tendency to induce bone metastases with concomitant general suffering, impaired mobility, and reduced self-sufficiency. The treatment of bone pain consists of opioids, nonsteroidal anti-inflammatory drugs, radiopharmaceuticals, and radiotherapy. To date, abiraterone, enzalutamide, zoledronate and denosumab are the only drugs able to delay skeletal events, and docetaxel is the only chemotherapeutic agent able to prolong survival after castration progression. Recently, 5 new drugs have proven to be efficacious in prolonging survival. Sipuleucel-T, cabazitaxel, abiraterone, enzalutamide, and radium-223 have broadened the therapeutic choices, thus changing the clinical paradigm. This review analyzes the data supporting the use of all presently available therapeutic approaches for the management of pain, skeletal events, and survival in castration-resistant prostate cancer patients with bone metastases. Data based on phase 3 trials could identify new approaches depending on patient, disease, and therapy characteristics.
authors: Oncologia Medica 1-Istituto Oncologico Veneto - IRCCS, Padova, Italy. Electronic address: fable.zustovich@ioveneto.it.
authors: Fable
authors: F
authors: Zustovich
authors: Department of Emergency-Urgency, San Giuseppe General Hospital, Empoli (Florence), Italy.
authors: Francesca
authors: F
authors: Fabiani
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D001842:Bone and Bones / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications / Q000188:drug therapy; D059408:Pain Management; D011467:Prostate / Q000187:drug effects* / Q000473:pathology; D064129:Prostatic Neoplasms, Castration-Resistant / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents
keywords: Abiraterone; Bone metastases; Cabazitaxel; Castration-resistant prostate cancer; Docetaxel; Enzalutamide; Radium-223