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Open Access Review

Challenges to improved therapeutics for metastatic castrate resistant prostate cancer: from recent successes and failures

Xuan Huang1, Cindy H Chau12 and William D Figg12*

Author Affiliations

1 Medical Oncology Branch, National Cancer Institute, NIH, Building 10, RM 5A01, 9000 Rockville Pike, Bethesda, MD, 20892, USA

2 Molecular Pharmacology Section, Medical Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA

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Journal of Hematology & Oncology 2012, 5:35  doi:10.1186/1756-8722-5-35

Published: 2 July 2012

Abstract

Men with metastatic castration-resistant prostate cancer (mCRPC) carry poor prognosis despite the use of docetaxel-based regimens which has modest survival benefit shown by randomized clinical trials. Significant progress in the discovery of novel therapeutic agents has been made in the past few years. While sipuleucel-T, cabazitaxel, and abiraterone gained regulatory approval in 2010 and 2011, several highly promising candidates/regimens have failed in large scale clinical trials. Challenges remain to optimize the design and interpretation of clinical trial results and develop more effective strategies for mCRPC. In this review, we examined the positive and negative clinical trials in mCRPC in the past and discussed the various aspects of clinical trial design including selection of targets and appropriate outcome measures, biomarker development and implementation, and strategies for combination therapy.