Targeted therapy for advanced prostate cancer: Looking through new lenses

Prostate cancer is the most common noncutaneous malignancy in men and also the third leading cause of death due to cancer in males. The conventional initial therapy for localized advanced or metastatic disease is hormone or androgen deprivation therapy. Although hormone-based therapies generally result in rapid responses, the disease then progresses to a phase when they fail to control the malignancy despite castrate testosterone levels. Some patients with castration-resistant prostate cancer continue to respond to secondary hormonal manipulations, and docetaxel-based chemotherapy improves median survival to about 18 months. Prostate cancer is termed hormone-refractory when it no longer responds to hormonal therapy. Currently, other therapeutic options, such as radical prostatectomy, radiation therapy or cryotherapy offer improvement in survival mostly in early stages. New therapy approaches based on a deeper understanding of especially metastatic prostate cancer are of vital importance. Here we discuss up-to-date clinical trials of agents with novel targets and present paradigms in prostate cancer vaccine therapy, metastasis suppressor genes, and some provocative findings on combination therapies of cytotoxic agents, which might provide a platform for developing effective treatment for advanced prostate cancer.