[The modern treatment of metastatic castration-resistant prostate cancer]

Zsófia Küronya1, Krisztina Biró1, Anikó Maráz2

  • 1Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary. kuronyaz@gmail.com.

Magyar Onkologia
|March 20, 2019
PubMed

Insights

Androgen deprivation therapy is standard for metastatic prostate cancer, but resistance leads to castration-resistant prostate cancer. New treatments have improved survival, with advancements for both metastatic and nonmetastatic stages.

Area of Science:

  • Oncology
  • Urology
  • Medical Therapeutics

Background:

  • Androgen deprivation therapy (ADT) is the cornerstone for metastatic prostate carcinoma.
  • Therapy resistance frequently emerges, progressing to castration-resistant prostate cancer (CRPC).
  • Significant advancements have been made in CRPC treatment since 2010.

Purpose of the Study:

  • To review the current standard of care for metastatic CRPC based on disease stage.
  • To introduce emerging treatment modalities currently under clinical investigation.
  • To discuss unresolved questions in CRPC management.

Main Methods:

  • Review of recent therapeutic advancements and clinical trial data for CRPC.
  • Analysis of treatment strategies for different stages of CRPC.
  • Synthesis of information on novel agents and therapeutic approaches.

Main Results:

  • Six new active substances registered since 2010 have significantly improved overall survival in metastatic CRPC.
  • Treatments targeting the androgenic axis, immunotherapy, chemotherapy, isotope therapy, and RANK-ligand inhibition are key modalities.
  • 2018 marked a milestone with FDA authorization of apalutamide and enzalutamide for nonmetastatic CRPC.

Conclusions:

  • The management of CRPC has evolved substantially, offering improved outcomes for patients.
  • Emerging therapies hold promise for further enhancing treatment efficacy and patient survival.
  • Continued research and clinical trials are crucial to address remaining challenges in CRPC care.

Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.7K
Modern Molecular Taxonomy01:29

Modern Molecular Taxonomy

Advancements in molecular biology have revolutionized the identification and characterization of bacteria, with multiple methods leveraging DNA sequencing for enhanced precision. As sequencing technologies improve and costs decline, these approaches are increasingly used in clinical, environmental, and evolutionary studies.Multilocus Sequence Typing (MLST) examines several housekeeping genes, essential chromosomal genes encoding cellular functions, to distinguish strains. Approximately...
666
Resistivity01:22

Resistivity

When a voltage is applied to a conductor, an electrical field is generated, and charges in the conductor feel the force due to the electrical field. The current density that results depends on the electrical field and the properties of the material. In some materials, including metals at a given temperature, the current density is approximately proportional to the electrical field. In these cases, the current density can be modeled as:
4.5K
Resistance01:19

Resistance

When a current moves through any conductor, the conductor causes some level of difficulty for the current to flow. The measure of that difficulty is known as the resistance of the material and is represented by R. Every material has its own resistance. In the case of conductors, heat is emitted whenever a current passes through them. Resistance depends on the resistivity of the material. Resistivity is a characteristic of the material used to fabricate electrical components, whereas the...
5.9K
Resistance and Conductance01:25

Resistance and Conductance

A conductor's DC resistance at a given temperature is influenced by its resistivity, length, and cross-sectional area. Resistivity is an inherent property of the conductor material, with annealed copper serving as the international standard for measurement. For instance, the resistivity of hard-drawn aluminum at 20 degrees Celsius is 61% of the standard conductivity of annealed copper.
Various factors impact the resistance of a conductor. Spiraling in stranded conductors increases their...
508
Equivalent Resistance01:16

Equivalent Resistance

In circuit analysis, situations often arise where resistors are neither in series nor parallel configurations. To tackle such scenarios, three-terminal equivalent networks like the wye (Y) (Figure 1 (a)) or tee (T) and delta (Δ) (Figure 1 (b)) or pi (π) networks come into play. These networks offer versatile solutions and are frequently encountered in various applications, including three-phase electrical systems, electrical filters, and matching networks.
976