Currently, the standard therapy for advanced prostate cancer is endocrine therapy(luteinizing hormone-releasing hormone [LH-RH]agonists alone or LH-RHagonists plus antiandrogens).
However, most patients eventually become resistant to these therapies as well as castration therapy. New endocrine therapies for castration-resistant prostate cancer(CRPC)have been developed. Abiraterone, a CYP17 inhibitor, and enzalutamide, a novel androgen receptor antagonist, have been shown to improve the overall survival, and they are set to be approved in Japan soon. Moreover, docetaxel and cabazitaxel have been established as first- and second-line chemotherapeutic drugs, respectively. Although there is currently no established molecular target drug for CRPC, some drugs such as cabozantinib seem to be effective, and they may be used in the future. In these situations of new drug development, the contribution of medical oncologists is predictable. While medical oncologists cannot play central roles in all aspects of drug therapy for urological malignancies in Japan, they must play roles in certain aspects such as new drug development starting from phase I trials, improving multidisciplinary care for adverse events, and promoting translational research.
Takahashi S. Are you the author?
Dept. of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research.
Reference: Gan To Kagaku Ryoho. 2014 Jul;41(7):827-31.