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mCRPC therapies: choices and questions


mCRPC therapies: choices and questions


In 2004, docetaxel demonstrated a modest, yet meaningful survival and pain palliative benefit. Since then, we have seen the approval of sipuleucel-T, cabazitaxel, abiraterone, enzalutamide and radium-223 broaden the menu of agents that prolong overall survival in metastatic castration-resistant prostate cancer (mCRPC). Although each is moderately effective, none of these agents offer a cure and the biologic and clinical data to explain mechanisms of drug resistance remains scanty at best. As a result, the field must now rely on practical considerations, with much data extrapolation, to fuel logical utilization and sequencing of these therapies in hopes of achieving optimal patient outcomes. In this special issue, these new agents will be discussed thoroughly. This includes review of biologic mechanism of action, clinical efficacy and safety data, biomarkers and opinions on pragmatic use and combinations for future exploration. Although, the topics may be drug-focused, there is the inclusion of broad discussion on entire fields of therapy with historical and pre-clinical perspective. (Art by Xiang Chen)

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