Castration resistant prostate cancer: recent advances in novel therapeutic treatments

Abstract

Prostate cancer is a prevalent and deadly malignancy that poses challenges in diagnosis and treatment. It is the second most common cancer in men worldwide and the fifth leading cause of cancer-related deaths. This abstract provides an overview of current treatments and recent advances in the field of prostate cancer treatment, with a focus on metastatic castration-resistant prostate cancer (mCRPC). Current treatments for mCRPC include chemotherapy, endocrine therapy, and bone-targeting therapy. Chemotherapy drugs such as docetaxel and cabazitaxel are commonly used, but their efficacy is limited. Endocrine therapy, particularly androgen-receptor signaling inhibitors like abiraterone acetate, has shown significant clinical benefits. Bone-targeting therapies such as bisphosphonates and denosumab provide symptomatic relief for bone metastases. Recent advances in novel treatments have shown promise in improving outcomes for patients with mCRPC. Trials investigating the PARP inhibitor rucaparib have demonstrated longer progression-free survival, particularly in patients with BRCA mutations. The combination of talazoparib and enzalutamide has also shown improved progression-free survival and delayed the need for chemotherapy. Another promising treatment is darolutamide, which has been shown to reduce the risk of metastasis or death and extend metastasis-free survival. Immunotherapy, particularly sipuleucel-T and PROSTVAC, has shown potential in reducing mortality risk and increasing overall survival (OS) in mCRPC patients. The combination of sipuleucel-T with abiraterone acetate or enzalutamide has been found to be effective and safe. The introduction of lutetium Lu 177 vipivotide tetraxetan, a PSMA-targeted therapy, has shown improved OS in PSMA-positive mCRPC patients. Radium-223, a radioactive drug targeting bone metastasis, has also demonstrated improved OS and delayed skeletal-related events. These recent advances in prostate cancer treatment offer hope for improved outcomes for patients with mCRPC. Further research and clinical trials are needed to validate these findings and explore additional treatment options.