Current and emerging treatment modalities for metastatic castration-resistant XXXX .

@entity1 @entity263 @entity5 @entity229 @entity2664 @entity15513 @entity1205
@entity1205 -based therapy is established as the standard first-line chemotherapy in @entity1 with metastatic castration-resistant @entity263 (mCRPC), based on results from two landmark Phase III studies. However, prognosis remains poor, with a median survival of less than 2 years. There is no standard of care for @entity1 who progress during or after @entity1205 treatment, which represents a real unmet medical need. Several small retrospective studies suggest that @entity1 with mCRPC who responded to first-line @entity1205 -based therapy are sensitive to re-treatment, but a survival benefit in prospective randomized trials has not been demonstrated. Epithelial-stromal interactions in the @entity5 microenvironment appear to play a central role in @entity263 progression and response to therapy. Recent insights into the molecular mechanisms that underpin @entity263 progression have allowed the identification of potential therapeutic targets. New agents, including angiogenesis inhibitors, hormone therapies, chemotherapies, bone targeting agents, vaccines and immunotherapies are currently undergoing clinical development in @entity263 using @entity1205 as a backbone. Several Phase III studies have now been completed. Sipuleucel-T prolonged survival compared with placebo in asymptomatic or minimally symptomatic @entity1 with mCRPC. @entity15513 plus @entity229 prolonged survival in @entity1 with mCRPC who progressed during or after @entity1205 -based therapy compared with the active agent @entity2664 , plus @entity229 . Multidisciplinary management and optimization of the role and timing of new agents in this evolving treatment continuum will be critical to maximizing @entity1 outcomes. Identification of predictive markers and better gene expression profiling will be critical to tailoring therapies to individual @entity1 and disease states, whereas validated surrogate markers of overall survival will help accelerate drug approval.
