Authors: Amelia Altavilla, Roberto Iacovelli, Giuseppe Procopio, Daniele Alesini, Emanuela Risi, Giuseppe Maria Campennì, Antonella Palazzo and Enrico Cortesi

Amelia Altavilla

Corresponding author: altamelia@libero.it
Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy
These authors have contributed equally to this work.

Roberto Iacovelli

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy
These authors have contributed equally to this work.

Giuseppe Procopio

Department of Medical Oncology; Istituto Nazionale dei Tumori; Milan, Italy

Daniele Alesini

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy

Emanuela Risi

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy

Giuseppe Maria Campennì

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy

Antonella Palazzo

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy

Enrico Cortesi

Department of Radiology, Oncology and Human Pathology; “Sapienza” University of Rome; Rome, Italy

Abstract:
Current landscape of treatment of castration-resistant prostate cancer (CRPC) has recently changed. Cabazitaxel, a new taxane with potential antineoplastic activity, has been approved by Food and Drug Administration (FDA) after docetaxel failure. In a phase III trial, cabazitaxel showed increased overall survival (OS) compared with mitoxantrone (15.1 vs. 12.7 mo, HR 0.70, 95% CI 0.59–0.83, p < 0.0001). Furthermore, chemotherapy is not the only strategy available: several studies have shown as CRPC remains dependent on androgen receptor function for growth. Abiraterone acetate, an irreversible inhibitor of CYP17, has also been approved by FDA after docetaxel failure. In a phase III trial comparing abiraterone acetate to placebo, abiraterone showed improvement in OS (14.8 vs. 10.4 mo, HR 0.65, 95% CI 0.54–0.77; p < 0.0001).

This review will discuss current options and the ongoing trials for second-line treatment of CRPC including chemotherapy, hormonal therapies, antiangiogenetic and immune strategies.

Received: March 19, 2012; Accepted: June 20, 2012; Published Online: July 24, 2012

Preview: