Review Article

Castration-Resistant Prostate Cancer: Mechanisms, Targets, and Treatment

Table 1

Summary of the therapeutic impact of new drugs in CRPC treatment.

Reference, study phase, and patient numberEfficacy results PFS*, OS+ComparatorPSA levels/PSA RR#

DocetaxelTannock et al. [13]
Phase III; 1006 pts
Prolongation of median survival, decrease in serum PSA level, predefined reductions in pain and improvements of quality of lifeMitoxantroneReduced

CabazitaxelBono et al. [65]
Phase III; 755 pts
Improved OS (95% CI: 0.59–0.83, ) and median PFS (HR: 0·74, 0.64–0.86, )MitoxantroneReduced

Abiraterone acetateDe Bono et al. [26]
Phase III; 1195 pts
Prolongation of OS, time to PSA progression (10.2 versus 6.6 months; ), progression-free survival (5.6 months versus 3.6 months; ), and PSA response rate (29% versus 6%, )PlaceboReduced (>29%)

BicalutamideKucuk et al. [22]
Phase II; 52 pts
Decreases pain and improves symptom statusBaseline after 1st lineReduced (≥50% in 20% pts)
Lodde et al. [23]
Prospective trial;
38 pts
PSA response rateBaseline after antiandrogen manipulationReduced (44.7% pts)

DESSmith et al. [25]
Phase II; 21 pts
PSA response rateBaseline after 1st line hormonal therapyReduced (43% RR)

Sipuleucel-TKantoff et al. [15]
Phase III, 512 pts
Relative reduction of 22% in the risk of death as compared with the placebo group (hazard ratio, 0.78; 95% confidence interval (CI), 0.61 to 0.98; )PlaceboReduced (≥50% in 2.6%)

MDV3100Scher et al. [34]
Phase I-II
Phase III results
not available
NANANA

PatupiloneBeardsley et al. [63] Phase II, 83 ptsProlongation of PFS, PSA declines, and pain response (decline)DocetaxelReduced (≥50% in 46%)

EribulinBono et al. [65]
Phase II, 108 pts
PSA response rateBaseline (stratified by prior taxane exposure)Reduced
PROSTVAC-VFKantoff et al. [72]
Phase II; 125 pts
44% reduction in the death rate and an 8.5-month improvement in median OSControl empty vectors plus saline injectionsNA

Atrasentan (plus Docetaxel)Carducci et al. [75]
Phase III; 809 pts
Alkaline phosphatase and PSA levels were significantly lower in the treatment armDocetaxel and placeboReduced

Bevacizumab (plus Docetaxel)Kelly et al. [76]
Phase III; 1050 pts
Improvement in PFS, measurable disease response, and posttherapy PSA declinePlaceboReduced (≥50% in 69.5%)

IpilimumabNCT01057810
[77] Phase III
ongoing
NAPlaceboNA

SunitinibSonpavde et al.
[78] Phase II; 36 pts
PFS, PSA decline, pain controlNAReduced (≥50% in 12,1%)

*PFS: progression free survival; +OS: overall survival; #RR: response rate; pts: patients; NA: not available.