title: Optimal Sequencing of New Drugs in Metastatic Castration-Resistant Prostate Cancer: Dream or Reality?
abstract: The availability of new drugs capable of improving the overall survival of patients with metastatic castration-resistant prostate cancer has led to the possibility of using them sequentially in the hope of obtaining a cumulative survival benefit. The new agents have already been administered as third-line treatments in patients who have previously received them as second line in everyday clinical practice, but the efficacy of this practice is not yet supported by clinical trial data, and evidence of possible cross-resistance has reinforced the debate concerning the best sequence to use in order to maximise the benefit. Furthermore, the situation is further complicated by the possibility of administering new hormonal agents to chemotherapy-naïve patients, and novel chemotherapeutic agents to hormone-sensitive patients. This article critically reviews the available data concerning the sequential use of new drugs, and discusses the real evidence concerning their optimal positioning in the therapeutic strategy of metastatic castration-resistant prostate cancer.
authors.affiliation: Medical Oncology Department, Santa Chiara Hospital, Largo Medaglie d&#8216;Oro-38122 Trento, Italy. orazio.caffo@apss.tn.it.
authors.forename: Orazio
authors.initials: O
authors.lastname: Caffo
authors.forename: Andrea
authors.initials: A
authors.lastname: Lunardi
authors.forename: Chiara
authors.initials: C
authors.lastname: Trentin
authors.forename: Francesca
authors.initials: F
authors.lastname: Maines
authors.forename: Antonello
authors.initials: A
authors.lastname: Veccia
authors.forename: Enzo
authors.initials: E
authors.lastname: Galligioni
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D015195:Drug Design; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate