Current management of prostate cancer: dilemmas and trials

Abstract

ABSTRACT. The past decade has witnessed significant advances in our understanding of the biology of prostate cancer. Androgen ablation/androgen receptor inhibition remains as the mainstay of treatment for advanced prostate cancer. Our understanding of the biology of prostate cancer has increased exponentially owing to advances in molecular biology. With this knowledge many intriguing issues have come to light, which clinicians and scientists alike strive to answer. These include why prostate cancer is so common, what drives the development of prostate cancer at a molecular level, why prostate cancer appears refractory to many families of cytotoxic chemotherapeutics, and why prostate cancer preferentially metastasizes to bone. Two clinical forms of prostate cancer have been identified: indolent organ confined disease, which elderly men often die of, and aggressive metastatic disease. A method of distinguishing between these two forms of the disease at an organ-confined stage remains elusive. Understanding the mechanisms of castrate resistance is a further issue of clinical importance. New trials of treatments, including molecular agents that target prostate cancer from a range of angles, have been instituted over the past 10-15 years. We can look at these trials not only as a chance to investigate the effectiveness of new treatments but also as an opportunity to further understand the complex biology of this disease.

Targeting prostate cancer cells with hybrid elastin-like polypeptide/liposome nanoparticles

“…[4][5][6][7][8][9][10][11][12] Prostate cancer has been considered as chemorefractory for a long time. 13,14 Only in the past 10-15 years, good results have been achieved in clinic trials with taxane derivatives such as docetaxel (DTX) and cabazitaxel. However, disabling toxicities like fatigue and neuropathy limit optimal dosage, and therefore, only modest, life-prolonging effects have been achieved for prostate cancer patients.…”

Targeting prostate cancer cells with hybrid elastin-like polypeptide/liposome nanoparticles

“…[4][5][6][7][8][9][10][11][12] Prostate cancer has been considered as chemorefractory for a long time. 13,14 Only in the past 10-15 years, good results have been achieved in clinic trials with taxane derivatives such as docetaxel (DTX) and cabazitaxel. However, disabling toxicities like fatigue and neuropathy limit optimal dosage, and therefore, only modest, life-prolonging effects have been achieved for prostate cancer patients.…”

Targeting prostate cancer cells with genetically engineered polypeptide-based micelles displaying gastrin-releasing peptide

“…The therapeutic effects of chemotherapy drugs and potent anti-androgens like abiraterone and enzalutamide have been very limited and most patients succumbed to advanced malignancy despite this treatment (O'Hanlon Brown and Waxman, 2012). To date, the most significant anti-tumour responses have been achieved in clinical trials with taxane derivatives such as docetaxel (Gollan and Green, 2002) and cabazitaxel (Honary and Zahir, 2013).…”