New drugs in prostate cancer

Andrew J Armstrong1, Michael A Carducci

  • 1Prostate Cancer Research Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 1650 Orleans Street, Baltimore, MD 21231, USA.

Abstract

Insights

New therapeutic strategies are needed for hormone-refractory metastatic prostate cancer. This review covers emerging molecularly targeted therapies and combination approaches to improve patient survival beyond docetaxel chemotherapy.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Hormone-refractory metastatic prostate cancer (HRMPC) survival has improved with docetaxel chemotherapy.
  • However, modest survival benefits necessitate rationally designed therapeutic strategies.
  • Advanced HRMPC treatment requires novel approaches beyond current standards of care.

Purpose of the Study:

  • To review recent developments in the therapeutic approach to advanced metastatic hormone-refractory prostate cancer.
  • To discuss emerging molecularly targeted therapies, signal transduction inhibitors, stem-cell targeted therapy, anti-angiogenic compounds, vaccines, immunomodulating agents, differentiation agents, cytotoxics, and pro-apoptotic agents.
  • To focus on compounds with the greatest potential and rationale for use since docetaxel's 2004 approval.

Main Methods:

  • Review of clinical development of over 200 compounds for advanced prostate cancer.
  • Concentration on emerging targets and compounds with significant therapeutic potential.
  • Analysis of data from clinical trials and scientific literature.

Main Results:

  • Over 200 compounds are in clinical development for advanced prostate cancer, used alone or in combination.
  • Emerging therapies include molecularly targeted agents, signal transduction inhibitors, and immunomodulating compounds.
  • Several novel agents show promise for improving outcomes in HRMPC.

Conclusions:

  • Targeted molecular therapy offers significant opportunities for treating prostate cancer.
  • Understanding molecular determinants of progression and resistance is crucial for rational drug design.
  • Combination or sequential therapies may be necessary for substantial therapeutic progress in HRMPC.
  • Novel clinical trial methodologies can accelerate the identification of effective compounds.

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