ABSTRACT

Despite the initial response to androgen deprivation in metastatic prostate cancer, the disease gradually progresses to a hormone refractory state due to genetic alterations of androgen receptors of tumour cells.Today, docetaxel represents the first chemotherapeutic agent with an acceptable survival benefit for hormone-refractory prostate cancer. However, there is no standard of care for patients who progress during or after docetaxel treatment. Several small retrospective studies suggest that patients with castration resistant prostate cancer (CRPC) who responded to first-line docetaxel based therapy are sensitive to re-treatment, but a survival benefit has not been demonstrated yet. New agents including chemotherapies, hormonal treatments, immunotherapies, vaccines, angiogenesis inhibitors, and bone targeting agents are currently undergoing clinical development in advanced prostate cancer using docetaxel as a first-line chemotherapy. Several phase lll studies have now been completed. Among these, cabazitaxel, sipuleucel-T, and abiraterone acetate, all were approved by the USA Food and Drug Administration (FDA), seem to be new standard of care for metastatic CRPC patients in post-docetaxel setting.