Abstract
Over the past several years, there have been significant advances in treatments and outcomes in metastatic castrate resistant prostate cancer (CRPC), with multiple new drugs with varying mechanisms gaining U.S. FDA approval. Despite these improvements, treatment resistance emerges within 1–2 years and metastatic CRPC remains incurable. Novel, rationally designed drugs and combination strategies are under investigation to further improve outcomes. Here we discuss a selection of these promising therapies in metastatic CRPC. Trials of immunotherapy with checkpoint blockade in CRPC are underway to try to match the success already found in melanoma and lung cancer. New drugs are being designed to target the AR-V7 splice variant, which has provided a mechanism for disease evasion of current hormonal therapies such as abiraterone and enzalutamide. Antibody-drug conjugates are being designed to allow for more specific delivery of drug to cancer cells in hopes of improving efficacy while decreasing systemic toxicity. Targeting stemness pathways such as Hedgehog and Notch signaling may provide a way to block self-renewing stem-like cells. Treatment with antisense oligonucleotides may be used to turn off genes of the cancer itself. Finally, identifying each drug’s appropriate place in the treatment algorithm, as well as obtaining synergy through combination therapy, will continue to improve outcomes for men with CRPC.
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Lash, T., Bitting, R.L. (2016). Novel Therapies in Castration-Resistant Prostate Cancer. In: Balaji, K. (eds) Managing Metastatic Prostate Cancer In Your Urological Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-31341-2_15
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DOI: https://doi.org/10.1007/978-3-319-31341-2_15
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