Update on options for treatment of metastatic castration-resistant prostate cancer

Figures & data

Table 1 Current treatment options for patients with castration-resistant prostate cancer²

Secondary hormonal therapies

Withdrawal responses (eg, antiandrogens, megestrol acetate)

Antiandrogen administration (flutamide, bicalutamide, nilutamide)

Adrenal suppressants (ketaconzole, aminoglutethimide)

Glucocorticoids (eg, dexamethasone, prednisone)

Estrogens (eg, DES, fosfestrol, estramustine)

Bisphosphonates (Zoledronate)

External-beam radiation therapy

Bone-seeking radiopharmaceuticals (samarium, strontium)

Chemotherapies (eg, mitoxantrone, docetaxel)

Experimental therapies

Abbreviation: DES, diethylstilbestrol.

Table 2 Active phase III trials in first-line chemotherapy for CRPC¹⁹

Study identifier	Study drug	Mechanism of action	Start date	Primary endpoint
NCT00255606	Docetaxel/Prednisone every 3 weekly vs 2 weekly (PROSTY)	Taxane (antimitotic, antimicrotubule agent)	Aug-05	TTF
NCT00887198	Abiraterone Acetate + Prednisone	CYP17A1 inhibitor	Apr-09	OS, PFS
NCT00554229 lNCT00617669	ZD4054 (ENTHUSE M0; ENTHUSE M1)	Endothelin A receptor antagonist	Nov-07	OS
NCT00744497	Docetaxel/Prednisone + Dasatinib	Multi-target Tyrosine Kinase inhibitor	Oct-08	OS
NCT00110214	Docetaxel/Prednisone + Bevacizumab	VEGF blocking monoclonal antibody	Apr-05	OS
NCT00134056	Docetaxel/Prednisone + Atrasentan	Endothelin A receptor antagonist	Aug-06	PFS
NCT00626548	Docetaxel/Prednisone + ZD4054	Endothelin A receptor antagonist	Jan-08	OS
NCT00519285	Docetaxel/Prednisone + Aflibercept (VENICE)	Soluble decoy receptor for VEGF	Aug-07	OS

Abbreviations: CRPC, castration-resistant prostate cancer; OS, overall survival; PFS, progression-free survival.

Table 3 Active phase II trials in second-line chemotherapy for CRPC¹⁹

Study identifier	Study drug	Mechanism of action	Start date	Primary endpoint
NCT00638690	Abiraterone Acetate + Prednisone	CYP17A1 inhibitor	Apr 2009	OS
NCT00974311	MDV3100 (AFFIRM)	AR antagonist	Sep 2009	OS
NCT00861614	Ipilimumab	CTLA-4 blocking monoclonal antibody	May 2009	OS
NCT0065442	Sipuleucel-T	Active cellular immunotherapy	Jul 2003	Safety and efficacy
NCT00676650	Sunitinib + Prednisone	Multitarget Tyrosine Kinase inhibitor	Jul 2008	OS
NCT00417079	XRP6258 + Prednisone vs Mitoxantrone + Prednisone	Taxane with a low affinity for P-gp	Dec 2006	OS

Abbreviations: CRPC, castration-resistant prostate cancer. OS, overall survival.

DeVitaVTLawrenceTSRosenbergSACancer Principles and Practice of Oncology8th ed200813921445

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National Institutes of Health Clinical Trials. 2009Available from: http://clinicaltrials.gov/ Accessed on December 10, 2009.

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