Current paradigms and evolving concepts in metastatic castration-resistant prostate cancer
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Updated: Jun 1, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Sumanta Kumar Pal1, Oliver Sartor
1Division of Genitourinary Malignancies, Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Los Angeles, CA, USA.
Abstract:
Until recently, docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The past year and a half has been marked by unprecedented progress in treatments for this disease. Three positive phase III clinical trials have emerged, each evaluating agents (sipuleucel-T, cabazitaxel and abiraterone) with distinct mechanisms of action. Herein, the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC. The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past. We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome. The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC.
Insights
Recent advancements offer new therapies for metastatic castration-resistant prostate cancer (mCRPC), significantly improving patient survival. Evaluating these novel treatments requires rigorous randomized trials due to evolving prognoses.
Area of Science:
- Oncology
- Urology
- Clinical Trials
Background:
- Docetaxel was the sole survival-prolonging therapy for metastatic castration-resistant prostate cancer (mCRPC).
- Recent progress has introduced novel therapeutic agents for mCRPC.
- The landscape of mCRPC treatment has rapidly evolved.
Purpose of the Study:
- To review three pivotal Phase III trials of novel agents in mCRPC.
- To compare current trial outcomes with historical data.
- To discuss factors influencing survival metrics and the need for randomized trials.
Main Methods:
- Description of three pivotal Phase III clinical trials.
- Analysis of historical and contemporary Phase III studies in mCRPC.
- Discussion of potential biases affecting survival outcome interpretation.
Main Results:
- Three new agents (sipuleucel-T, cabazitaxel, abiraterone) with distinct mechanisms show efficacy.
- Overall survival in current mCRPC trials is notably longer than in past studies.
- Improved survival observed even with older agents in recent trials.
Conclusions:
- Novel therapies are significantly improving outcomes for mCRPC patients.
- Increased survival rates necessitate careful interpretation of trial data.
- Randomized controlled trials are essential for validating new mCRPC therapeutics.
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