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Minerva Urologica e Nefrologica 2018 February;70(1):22-41

DOI: 10.23736/S0393-2249.17.02976-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Castration-resistance prostate cancer: what is in the pipeline?

Cosimo DE NUNZIO 1 , Fabrizio PRESICCE 1, Silvana GIACINTI 2, Maria BASSANELLI 2, 3, Andrea TUBARO 1

1 Department of Urology, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy; 2 Department of Oncology, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy; 3 Department of Oncology, San Camillo De Lellis Hospital, Rieti, Italy


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INTRODUCTION: To evaluate the available evidence on the standard diagnosis and management of men with metastatic castration resistant prostate cancer (mCRPC), and providing the timely update on new pharmacological treatments.
EVIDENCE ACQUISITION: A systematic literature search from from January 2000 until March 2017 was performed by combining the following MESH terms: castrate resistant prostate cancer, abiraterone, enzalutamide, 223radium, sipuleucel-T, docetaxel, cabazitaxel, resistance mechanisms, resistance to androgen deprivation, androgen receptor (AR) mutations, amplifications, splice variants, and AR alterations. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).
EVIDENCE SYNTHESIS: In the few last years the introduction of new treatment modalities as abiraterone or enzalutamide have significantly change our prospective in mCRPC management increasing patients survival and quality of life. The standard imaging modalities to define the presence of regional or distant metastasis or the different resistant mechanisms to the available treatments are still an issue of debate, however several studies are ongoing to define the standard of care and to reduce treatments’ resistance. Data from ongoing phase III trials are awaited to introduce in clinical new effective treatments that can be used in patients resistant to abiraterone/enzalutamide or more probably in a different phase of the disease.
CONCLUSIONS: Castration resistant prostate cancer is now the key issue in prostate cancer management and research. Our challenge in the near future will be to identify the right treatment or better the right combination and sequencing of treatments that should be used in patients with mCRPC or even with advanced prostate cancer.


KEY WORDS: Prostatic neoplasms, castration-resistant - Diagnosis - Drug therapy

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Publication History

Issue published online: January 30, 2018
Article first published online: July 12, 2017
Manuscript accepted: June 28, 2017
Manuscript received: May 23, 2017

Per citare questo articolo

De Nunzio C, Presicce F, Giacinti S, Bassanelli M, Tubaro A. Castration-resistance prostate cancer: what is in the pipeline? Minerva Urol Nefrol 2018;70:22-41. DOI: 10.23736/S0393-2249.17.02976-9

Corresponding author e-mail

fabriziopresicce@libero.it