Chemotherapy options in castration-resistant prostate cancer

Benjamin A. Teply, Ralph J. Hauke

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Introduction: The treatment landscape for patients with metastatic castration-resistant prostate cancer (CRPC) is evolving, with recent approvals of immune therapy, novel hormonal therapy, and bone-targeted therapy. Chemotherapy remains an essential component of the armamentarium. Herein, we review current chemotherapy options for patients with CRPC and discuss future challenges. Methods: We reviewed literature for chemotherapy agents in prostate cancer, with special attention to the evidence for efficacy of the currently approved agents. We also reviewed emerging data on biomarkers of response to chemotherapy for CRPC. Results: Taxanes, especially docetaxel and cabazitaxel, have first- and second-line indications for CRPC, respectively, with both providing a survival benefit. Multiple attempts to improve on the single agent efficacy of docetaxel with combination therapy have not generally been successful although platinum combinations are used for resistant phenotypes. Reductions in prostate-specific antigen by ≥30% and reductions in circulating tumor cells (CTCs) to ≤ 5 are associated with improved survival on chemotherapy. Chemotherapy may continue to be effective therapy for patients with biomarkers that are associated with resistance to androgen-directed therapies (androgen receptor splice variant 7 positivity in CTCs or high CTC heterogeneity). Conclusions: Chemotherapy remains an essential component of CRPC therapy, and biomarkers are being identified to define clinical scenarios where chemotherapy may be the optimal therapy choice.

Original languageEnglish (US)
Pages (from-to)262-270
Number of pages9
JournalIndian Journal of Urology
Volume32
Issue number4
DOIs
StatePublished - Oct 1 2016

Fingerprint

Castration
Prostatic Neoplasms
Drug Therapy
docetaxel
Circulating Neoplastic Cells
Therapeutics
Biomarkers
Taxoids
Survival
Androgen Receptors
Prostate-Specific Antigen
Tumor Biomarkers
Platinum
Androgens
Phenotype
Bone and Bones

Keywords

  • Biomarkers
  • chemotherapy
  • prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Chemotherapy options in castration-resistant prostate cancer. / Teply, Benjamin A.; Hauke, Ralph J.

In: Indian Journal of Urology, Vol. 32, No. 4, 01.10.2016, p. 262-270.

Research output: Contribution to journalArticle

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