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Updated: May 17, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
New agents for the management of castration-resistant prostate cancer
1Veterans Administration Medical Center, Boston, MA, USA. r.cersosimo@neu.edu
Objective:
To review the activity of 3 new agents approved for the management of advanced castration-resistant prostate cancer (CRPC): sipuleucel-T, cabazitaxel, and abiraterone acetate.
Data Sources:
Literature was accessed through MEDLINE (1977-June 2012) and abstracts from the American Society of Clinical Oncology (2000-2012) using the terms castration-resistant and hormone-refractory prostate cancer, sipuleucel-T, cabazitaxel, abiraterone, Provenge, Jevtana, and Zytiga. Reference citations from publications identified were also reviewed.
Study Selection And Data Extraction:
Articles identified from the data sources in English on human subjects were evaluated.
Data Synthesis:
Options for patients with CRPC have been limited, with little to offer those who failed or could not tolerate docetaxel-based therapy. Three new drugs, with very different mechanisms of action, have changed that and will undoubtedly change the treatment paradigm for these patients. Each agent has demonstrated an impact on patient survival. Sipuleucel-T, the first immunotherapy approved for treatment of CRPC, improved median overall survival by 4.1 months and reduced the risk of death by 22% in a placebo-controlled trial of asymptomatic patients. Sipuleucel-T can be administered prior to docetaxel-based therapy. Cabazitaxel, a taxane chemotherapy agent, improved median overall survival by 2.4 months and reduced the risk of death by 30% in a Phase 3 trial of patients whose cancer progressed during or after docetaxel-based therapy. Abiraterone acetate, a hormonal therapy, improved median overall survival by 3.9 months and reduced the risk of death by 35% in patients with relapse during or after docetaxel-based therapy.
Conclusions:
The advent of new agents for the management of advanced CRPC has increased the choices for patients whose options were limited. Additional experience will determine the optimal sequencing of these agents, their roles in combination therapy, and their activity in patients with earlier disease.
Insights
Three new agents, sipuleucel-T, cabazitaxel, and abiraterone acetate, offer improved survival for advanced castration-resistant prostate cancer (CRPC) patients. These therapies provide new options for those with limited choices, impacting the treatment paradigm.
Area of Science:
- Oncology
- Pharmacology
- Immunotherapy
Background:
- Treatment options for advanced castration-resistant prostate cancer (CRPC) were historically limited, particularly for patients who failed or could not tolerate docetaxel-based chemotherapy.
- The emergence of novel therapeutic agents has significantly altered the management landscape for CRPC.
- This review focuses on three recently approved agents: sipuleucel-T, cabazitaxel, and abiraterone acetate.
Purpose of the Study:
- To review the clinical activity and impact of three new agents approved for advanced castration-resistant prostate cancer (CRPC).
- To evaluate sipuleucel-T, cabazitaxel, and abiraterone acetate in the context of limited treatment options for CRPC.
- To assess the survival benefits and potential roles of these novel therapies in the CRPC treatment paradigm.
Main Methods:
- A literature search was conducted using MEDLINE and American Society of Clinical Oncology abstracts (1977-2012).
- Keywords included 'castration-resistant prostate cancer,' 'hormone-refractory prostate cancer,' and specific drug names (sipuleucel-T, cabazitaxel, abiraterone, Provenge, Jevtana, Zytiga).
- Identified articles and reference citations in English concerning human subjects were evaluated.
Main Results:
- Sipuleucel-T, an immunotherapy, improved median overall survival by 4.1 months (22% reduced risk of death) in asymptomatic CRPC patients.
- Cabazitaxel, a taxane chemotherapy, improved median overall survival by 2.4 months (30% reduced risk of death) in patients progressing on docetaxel.
- Abiraterone acetate, a hormonal therapy, improved median overall survival by 3.9 months (35% reduced risk of death) in patients relapsing on or after docetaxel.
Conclusions:
- The introduction of sipuleucel-T, cabazitaxel, and abiraterone acetate has expanded therapeutic choices for advanced CRPC patients.
- These agents demonstrate a significant impact on patient survival, altering the treatment paradigm.
- Further research is needed to determine optimal sequencing, combination therapy roles, and efficacy in earlier disease stages.
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