[How to manage patients with CRPC?]

Bull Cancer. 2015 Jun;102(6):509-15. doi: 10.1016/j.bulcan.2015.04.015. Epub 2015 May 28.
[Article in French]

Abstract

Despite castrate levels of androgens, the androgen receptor (AR) remains active and continues to drive prostate cancer progression. Since the approval of docetaxel, four additional agents that show a survival benefit have been registered on the basis of randomized phase 3 trials. These have included enzalutamide and abiraterone, two agents designed specifically to affect the androgen axis, sipuleucel-T, which stimulates the immune system and cabazitaxel, a chemotherapeutic agent. Denosumab was shown to significantly delay skeletal-related events. Clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision making more complex. The induction of constitutively-active AR splice variants (AR-Vs) driving clonal proliferation of AR-negative and AR-independent metastases may be one major potential mechanism of resistance to new hormone therapies.

Keywords: AR-V7; Abiraterone acetate; Acétate d’abiratérone; Alpharadin; Cabazitaxel; Cancer de prostate résistant à la castration; Denosumab; Docetaxel; Docétaxel; Dénosumab; Enzalutamide; Metastatic castration-resistant prostate cancer; Sipuleucel-T; Splicing variants; Variants épissage.

Publication types

  • Review

MeSH terms

  • Abiraterone Acetate
  • Androstenes / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Benzamides
  • Bone Neoplasms / prevention & control
  • Bone Neoplasms / secondary
  • Clinical Trials, Phase III as Topic
  • Denosumab
  • Docetaxel
  • Humans
  • Male
  • Nitriles
  • Phenylthiohydantoin / analogs & derivatives
  • Phenylthiohydantoin / therapeutic use
  • Prednisone / therapeutic use
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / metabolism
  • Receptors, Androgen / metabolism*
  • Taxoids / therapeutic use
  • Tissue Extracts / therapeutic use

Substances

  • Androstenes
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Benzamides
  • Nitriles
  • Receptors, Androgen
  • Taxoids
  • Tissue Extracts
  • Docetaxel
  • Phenylthiohydantoin
  • Denosumab
  • cabazitaxel
  • sipuleucel-T
  • enzalutamide
  • Abiraterone Acetate
  • Prednisone