Therapies for castration‐resistant prostate cancer in a new era: The indication of vintage hormonal therapy, chemotherapy and the new medicines

Abstract

Abbreviations & Acronyms AIPC = androgenindependent prostate cancer AR = androgen receptor AR-V7 = androgen receptor splice variant 7 BSC = best supportive care BSI = Bone Scan Index CAB = combined androgen blockade CRPC = castration-resistant prostate cancer HHSPC = hormonehypersensitive prostate cancer PFS = progression-free survival PSA = prostate-specific antigen Ra-223 = radium-223 Abstract: When advanced prostate cancer recurred during hormonal therapy and became the castration-resistant prostate cancer, "vintage hormonal therapy," such as antiandrogen alternating therapy or estrogen-related hormonal therapy, was widely carried out in Japan until 2013. This vintage hormonal therapy controlled the progression of castration-resistant prostate cancer. When castration-resistant prostate cancer relapses during these therapies, chemotherapy using docetaxel has been carried out subsequently. Since new hormonal therapies using abiraterone acetate and enzalutamide, which improve the prognosis of castration-resistant prostate cancer, became available in Japan from 2014, therapeutic options for castration-resistant prostate cancer have increased. Furthermore, the improvement of the further prognosis is promising by using cabazitaxel for docetaxel-resistant castration-resistant prostate cancer and radium-223 for castration-resistant prostate cancer with bone metastasis. An increase in therapeutic options gives rise to many questions, including best timing to use them and the indication. Furthermore, physicians have to consider the treatment for the recurrence after having carried out chemotherapy. We want to argue the difference in hormonal therapy between Japan and Western countries, and problems when carrying out new treatments, and the importance of imaging in the present review article.

Treatment effects in prostate cancer

“…Chemotherapy options for castrate-resistant prostate cancer include cabiztaxel, docetaxel, mitoxantrone, and estramustine. 50 Changes specific to these agents are best described in clinical trials involving neoadjuvant treatment before prostatectomy in the absence of the confounding influence of prior ADT or RT. O'Brien et al 51 described treatment-induced histopathologic changes in 50 high-risk prostate cancer patients treated with pre-prostatectomy docetaxel and mitoxantrone.…”

Identification of zinc finger protein of the cerebellum 5 as a survival factor of prostate and colorectal cancer cells

“…For drug selection, drug sensitivity is critical for preventing survival and drug resistance of cancer cells. Although the development of molecular targeted drugs has become popular in many diseases, DNA replication‐inhibiting drugs such as fluorouracil and platinum‐containing drugs are commonly used for aggressive PCa and CRC in which intolerable side‐effects are serious problems . Thus, the identification of novel therapeutic targets to enhance drug sensitivity is required for the development of efficacious strategies.…”

“…Although the development of molecular targeted drugs has become popular in many diseases, DNA replication-inhibiting drugs such as fluorouracil and platinum-containing drugs are commonly used for aggressive PCa and CRC in which intolerable side-effects are serious problems. (1,2,24,25) Thus, the identification of novel therapeutic targets to enhance drug sensitivity is required for the development of efficacious strategies. In this study, we found that ZIC5 positively regulated the proliferation, migration (Fig.…”

Cabazitaxel in patients aged ≥80 years with castration-resistant prostate cancer: Results of a post-marketing surveillance study in Japan

“…Since 2008, chemotherapy with docetaxel was the main treatment option for patients with CRPC. More recently, several new treatment options were introduced, including the androgen signaling inhibitors enzalutamide and abiraterone, radium-223, and the new taxane, cabazitaxel [6,7]. These four drugs are now recommended for the treatment of CRPC in several guidelines for PC [8].…”