Abiraterone is licensed for use in combination with prednisone for treatment of patients with metastatic castration-resistant PCa (mCRPC), who have received prior chemotherapy containing docetaxel; the application has been filed in the EU.
It became the first immunotherapy approved for use in prostate cancer after demonstrating a significant overall survival benefit in asymptomatic or minimally symptomatic mCRPC (Kantoff et al, 2010a).
Looking to new prognostic and predictive values for survival in mCRPC, we analysed the role of baseline TL and other potential factors (such as haemoglobin) in a cohort of patients with mCRPC.
This article describes the preclinical rationale for the use of combination dasatinib and docetaxel therapy in mCRPC, and highlights the results of a phase I II trial in which 46 patients with mCRPC, treated with a regimen of dasatinib and docetaxel, demonstrated improvements in bone scans, high rates of soft tissue responses, and modulation of markers of bone turnover.
The approval for use of enzalutamide for patients with mCRPC previously treated with docetaxel is based on the results of the randomised, phase III, double-blind, placebo-controlled, multinational AFFIRM trial (NCT00974311), with a primary end point of OS 6.
While recently completed clinical trials failed to demonstrate survival benefit for GVAX in mCRPC, a second experimental vaccine based on similar cell lines but engineered to express interleukin-2 and interferon-β, is also being studied in patients with mCRPC.
Radium-223 dichloride has also been approved for patients with mCRPC with metastases to bone but not other organs.
This manuscript will review the preclinical and clinical development of Ra, and comment on its potential role and use in the armamentarium of therapy for mCRPC.
Finally, there is a need for improved serum biomarkers in mCRPC.
We prospectively assessed categorical and continuous CTC-counts for their utility in early prediction of radiographic response, progression-free (PFS) and overall survival (OS) in mCRPC patients treated with docetaxel.
