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Updated: May 3, 2026
Generation of Prostate Cancer Cell Models of Resistance to the Anti-mitotic Agent Docetaxel
Published on: September 8, 2017
Sequential use of novel therapeutics in advanced prostate cancer following docetaxel chemotherapy
Aurelius Omlin1, Carmel Pezaro2, Silke Gillessen Sommer3
1Kantonsspital St Gallen, Abteilung fuer Medizinische Onkologie, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland.
Abstract:
In the last three years, five novel treatments have been shown to improve survival in metastatic castration-resistant prostate cancer (CRPC). These novel treatments have distinct mechanisms of action: tubulin-binding chemotherapy (cabazitaxel); immunotherapy (sipuleucel-T); CYP-17 inhibition (abiraterone); androgen receptor (AR) blockade (enzalutamide); and radioisotope therapy (radium-223). For a number of years, docetaxel was the only treatment with a proven survival benefit for patients with CRPC. Therefore, somewhat artificially, three treatment spaces for drug development in CRPC have emerged: pre-docetaxel; docetaxel combinations; and post-docetaxel. For patients progressing after docetaxel-based chemotherapy, treatment options available outside of clinical trials now include abiraterone, cabazitaxel and enzalutamide. Prospective data on how to best use these novel agents sequentially are not available. Clinicians face the difficult task of choosing between treatment options for individual patients to maximize patient benefit. Treatment evaluation in patients with CRPC remains challenging due to the predominance of bone metastatic disease and the lack of validated surrogate markers for survival. This review summarizes the data available with regards to sequencing of the novel treatments for CRPC.
Insights
Five novel treatments now improve survival in metastatic castration-resistant prostate cancer (CRPC). This review examines sequencing data for these agents after docetaxel chemotherapy to guide clinical decisions.
Area of Science:
- Oncology
- Medical treatment
Background:
- Metastatic castration-resistant prostate cancer (CRPC) survival has improved with five novel treatments.
- Docetaxel was previously the sole option with proven survival benefit.
- Novel agents include cabazitaxel, sipuleucel-T, abiraterone, enzalutamide, and radium-223.
Purpose of the Study:
- To review available data on sequencing novel CRPC treatments.
- To aid clinicians in selecting optimal sequential therapies for individual patients.
Main Methods:
- Literature review of prospective data on novel CRPC treatments.
- Analysis of treatment efficacy and sequencing in the post-docetaxel setting.
Main Results:
- Abiraterone, cabazitaxel, and enzalutamide are options for patients progressing after docetaxel.
- Prospective data on optimal sequential use of these agents is limited.
- Treatment evaluation in CRPC is challenging due to bone metastases and lack of surrogate markers.
Conclusions:
- Sequencing novel agents in CRPC requires careful consideration due to limited prospective data.
- Further research is needed to establish optimal treatment sequences for improved patient outcomes.
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