Chemotherapy

Abstract

Nearly all patients with metastatic prostate cancer (PC) become resistant to the initial approach with androgen deprivation therapy (ADT), developing the state known as metastatic castration-resistant prostate cancer (mCRPC). For nearly a decade, chemotherapy with docetaxel has been the only established standard of care in this setting. In recent years, treatment of mCRPC has changed dramatically due to the improvement in the understanding of CRPC biology, which has revealed that during the progression to the castrate status, PC cells remain dependent on androgens and on the androgen receptor (AR) signaling pathway. Multiple novel agents that have demonstrated to improve OS, symptom control, and QoL in mCRPC have been approved, including sipuleucel-T, cabazitaxel, abiraterone acetate, enzalutamide, and radium-223. The optimal sequencing and combination of these treatments still need to be defined. However, chemotherapy with docetaxel and cabazitaxel remains an important therapeutic option for patients with mCRPC, with potential clinical effect on bone metastases.