Changing paradigms in management of metastatic Castration Resistant Prostate Cancer (mCRPC)

摘要: Recently, the standard of care for metastatic Castration Resistant Prostate Cancer (mCRPC) has changed considerably. Persistent androgen receptor (AR) signaling been identified as a target novel therapies and reengages fact that AR continues to be primary responsible prostate cancer. Androgen gene amplification over expression have found result in higher concentration receptors on tumor cells, making them extremely sensitive low levels circulating androgens. Additionally, cancer cells are able maintain dihydrotestosterone (DHT) excess serum concentrations support growth. For many years ketoconazole was only CYP17 inhibitor used treat mCRPC. However, significant toxicities limit its use. Newly approved chemotherapeutic agents such Abiraterone (an oral selective CYP17A), which blocks biosynthesis both within outside cells), enzalutamide (blocks signaling) improved overall survival. There also ongoing phase III trials Orteronel (TAK- 700), ARN- 509 Galeterone (TOK-001), targets signaling. In this review, we will present rationale newly hormonal treatments, their indications complications, discuss being done improve efficacy agents. Finally, talk about potential upcoming treatments