Sequencing of agents in castration-resistant prostate cancer

• Published in: The lancet oncology Vol. 16; no. 6; pp. e279 - e292
• Main Authors: Lorente, David, Mateo, Joaquin, Perez-Lopez, Raquel, de Bono, Johann S, Attard, Gerhardt
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2015; Elsevier Limited
• Subjects: Abiraterone Acetate; Androgens; Androstenes - therapeutic use; Antigens; Benzamides; Biomarkers; Biopsy; Cancer therapies; Clinical trials; Docetaxel; Hematology, Oncology and Palliative Medicine; Humans; Male; Metastasis; Mortality; Mutation; Neurotoxicity; Nitriles; Pain; Phenylthiohydantoin - analogs & derivatives; Phenylthiohydantoin - therapeutic use; Prostate cancer; Prostatic Neoplasms, Castration-Resistant - drug therapy; Prostatic Neoplasms, Castration-Resistant - epidemiology; Prostatic Neoplasms, Castration-Resistant - pathology; Quality of life; Radioisotopes - therapeutic use; Radium - therapeutic use; Response rates; Taxoids - therapeutic use; Tissue Extracts - therapeutic use; Treatment Outcome
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(15)70033-1

Until 2010, docetaxel was the only agent with proven survival benefit for castration-resistant prostate cancer. The development of cabazitaxel, abiraterone acetate, enzalutamide, radium-223, and sipuleucel-T has increased the number of treatment options. Because these agents were developed concurrently within a short period of time, prospective data on their sequential use efficacy are scarce. The challenge now is to reach a consensus on the best way to sequence effective treatments, ideally by the use of an approach specific to patient subgroups. However, the absence of robust surrogates of survival and the lack of predictive biomarkers makes data for the sequential use of these agents difficult to obtain and interpret.