Navigating the evolving therapeutic landscape in advanced prostate cancer

Prostate cancer is the most common cause of cancer in men, with 137.9 new cases per 100,000 men per year. The overall 5-year survival rate for prostate cancer is very high. Up to 20% of men who undergo state-of-the art treatment for prostate cancer will develop castration-resistant prostate cancer (CRPC) within 5 years, with median survival for those with metastatic CRPC ranging from approximately 15 to 36 months in recent studies. With the advent of several new drugs in the past 5 years to treat CRPC, the challenge facing clinicians is how to best sequence or combine therapies or both to optimize outcomes. A better understanding of the disease process and the role of the androgen receptor as a target for both therapy and resistance have led to the consideration of biomarkers as an approach to aid in selecting the appropriate agent for a given patient as patients respond to or tolerate different drugs differently. Research to identify new prognostic biomarkers, which are associated with outcome measures, as well as predictive biomarkers, which predict response or resistance to therapy is ongoing. The treatment of advanced prostate cancer and the research related to biomarkers are discussed.

Urologic oncology. 2017 Mar 07 [Epub ahead of print]

E David Crawford, Daniel Petrylak, Oliver Sartor

Department of Surgery, Section of Urologic Oncology, School of Medicine, University of Colorado Denver, Aurora, CO., Department of Medicine (Medical Oncology), Yale (Smilow) Cancer Center, New Haven, CT; Department of Urology, Yale (Smilow) Cancer Center, New Haven, CT., Department of Medicine, Tulane Cancer Center, New Orleans, LA; Department of Urology, Tulane Cancer Center, New Orleans, LA. Electronic address: .