Castrate Resistant Metastatic Prostate Cancer Options for a Patient in 2012英文文献资料.docVIP

Open Journal of Urology, 2012, 2, 210-215 /10.4236/oju.2012.223037 Published Online October 2012 (http://www.SciRP.org/journal/oju) Castrate Resistant Metastatic Prostate Cancer: Options for a Patient in 2012 Asim Ahmad , Winston Tan 1 2* 1 Internal Medicine Mayo Clinic Florida, Jacksonville, USA Division of Hematology, Oncology Mayo Clinic Florida, Jacksonville, USA Email: asim@, 2 * winston@ Received August 6, 2012; revised September 11, 2012; accepted September 28, 2012 ABSTRACT Castrate resistant metastatic prostate cancer remains a fatal disease. Through preclinical studies and clinical trials, a multitude of options have been made available to prolong the life of these patients, as well as improve quality of life. First line treatment options following tumor progression after androgen deprivation therapy include Provenge and do- cetaxel. Several options are available as second line treatment, including cabazitaxel, abiraterone, and enzalutamide. Many drugs currently being studied are very promising, such as alpharadin. Here we review treatment options for pa- tients suffering from disease progression after androgen deprivation therapy, and offer a review of the current available options for the clinician. Keywords: Castrate; Resistant; Prostate; Cancer; Treatment; Review 1. Introduction however, most of the secondary hormone manipulation techniques, despite achieving castrate levels of testoster- one, only temporarily control disease without improve- ment in overall survival; average median survival re- mains around 30 months. On average, after 12 - 18 mon- ths, the cancer develops resistance to therapy [4]. Analysis of tumor specimens from patients with CRPC have shown several mechanisms adapted by cancer cells to reactivate the androgen receptor (AR) signaling at sub-physiological serum concentrations of androgens, even in the presence of AR antagon