Role of second-line systemic treatment post-docetaxel in metastatic castrate resistant prostate cancer- current strategies and future directions

Anticancer Agents Med Chem. 2011 Mar;11(3):296-306. doi: 10.2174/187152011795347496.

Abstract

Treatment of metastatic castrate resistant prostate cancer (mCRPC) after progression on docetaxel chemotherapy is a challenging clinical scenario with limited availability of treatment options. Re-treatment with docetaxel, either as monotherapy or in combination with other cytotoxics or targeted agents has shown durable responses. However, most docetaxel re-treatment studies have been either retrospective or early phase non-randomised studies which have not formally assessed Quality of life or survival gain with re-treatment. Despite limited evidence for efficacy of mitoxantrone in the second-line, it continues to remain widely used, largely due to lack of available suitable alternatives. Cabazitaxel in combination with prednisolone is the only chemotherapy to have shown a significant survival benefit and receive approval by the U.S. Food and Drug Administration for patients with mCRPC previously treated with a docetaxel-based regimen. Abiraterone acetate has recently demonstrated a significant improvement in survival when compared to placebo in patients with docetaxel-treated mCRPC. This review aims to summarize the current evidence and discuss future strategies for treatment of mCRPC patients following failure of docetaxel chemotherapy.

Publication types

  • Review

MeSH terms

  • Androstenes
  • Androstenols / administration & dosage
  • Androstenols / therapeutic use
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clinical Trials as Topic
  • Disease Progression
  • Disease-Free Survival
  • Docetaxel
  • Drug Resistance, Neoplasm
  • Forecasting
  • Humans
  • Male
  • Mitoxantrone / administration & dosage
  • Mitoxantrone / therapeutic use
  • Neoplasm Metastasis
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology
  • Quality of Life
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use
  • Treatment Failure

Substances

  • Androstenes
  • Androstenols
  • Antineoplastic Agents
  • Taxoids
  • Docetaxel
  • cabazitaxel
  • Prednisolone
  • Mitoxantrone
  • abiraterone