New treatments for patients with non‐metastatic castration‐resistant prostate cancer: A nursing perspective

Castration Resistant ◽

Related Quality ◽

Impact On Survival ◽

Chemotherapy treatment options are limited for patients with castration-resistant prostate cancer (CRPC). The purpose of this study is to report treatment use and adverse effects (AEs) within the last three months of life in patients with CRPC. Of the 88 patients identified, 32% received treatment within 3 months of death, and documented AEs occurred in 25% of patients. Of those, neutropenia (18.3%), nausea/vomiting (18.3%), and febrile neutropenia (13.6%) were the most frequent. Results of this study show high treatment utility towards the end-of-life in patients with CRPC, with one fourth of patients experiencing AEs. Attention to health-related quality of life becomes increasingly important as new treatments appear to have small impact on survival, and AEs of those treatments may significantly impact patient quality of life.

Novel therapies and emerging strategies for the treatment of patients with castration-resistant prostate cancer

10.1093/med/9780199659579.003.0069 ◽

2017 ◽

Author(s):

Deborah Mukherji ◽

Aurelius Omlin ◽

Carmel Pezaro ◽

Johann De Bono

Keyword(s):

Prostate Cancer ◽

Abiraterone Acetate ◽

Phase Iii ◽

Trial Participation ◽

Clinical And Translational Research

Castration Resistant ◽

Radium 223 ◽

New Treatments ◽

Phase Iii Studies ◽

Castration-resistant prostate cancer (CRPC) represents a final stage of this malignancy for many men and is defined as the progression of prostate cancer despite castrate levels of testosterone. CRPC may present as a rising PSA, the development of new metastases, or worsening of known metastases. Recent advances have resulted in five new treatments for CRPC: the immunotherapy sipuleucel-T; the cytotoxic cabazitaxel; the androgen biosynthesis inhibitor abiraterone acetate; the radioisotope radium-223; and the antiandrogen enzalutamide. These have all improved overall survival in randomized phase III studies for patients with metastatic CRPC. Furthermore, multiple agents and combinations are currently in late-stage clinical testing. Men with advanced prostate cancer represent an important population for clinical and translational research and clinical trial participation should be considered as part of standard care.

Emerging Subtypes and New Treatments for Castration-Resistant Prostate Cancer

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_100025 ◽

2020 ◽

pp. e319-e332

Author(s):

Benedito A. Carneiro ◽

Tamara L. Lotan ◽

Andre de Souza ◽

Rahul Aggarwal

Keyword(s):

Prostate Cancer ◽

Parp Inhibitors ◽

Phase Iii ◽

Precision Oncology ◽

Castration Resistant ◽

Treatment Paradigm ◽

Genomic Characterization ◽

Sequential Treatments ◽

Genomic characterization of metastatic castration-resistant prostate cancer (mCRPC) has been remodeling the treatment landscape of this disease in the past decade. The emergence of molecularly defined subsets of mCRPC is altering the treatment paradigm from therapeutics with nonspecific activity across the spectrum, including androgen receptor (AR)-directed treatments, docetaxel, and cabazitaxel, to targeted approaches directed at molecular subsets of disease. The meaningful benefit of PARP inhibitors in mCRPC carrying mutations in DNA repair genes demonstrated in a phase III trial epitomizes this transition in the treatment paradigm of mCRPC and brings new challenges related to how to sequence and integrate the targeted therapies on top of the treatments with broad activity in all mCRPC. To enable and sustain the advance of precision oncology in the management of mCRPC, genomic characterization is required, including somatic and germline testing, for all patients with the ultimate goal of longitudinal molecular profiling guiding treatment decisions and sequential treatments of this lethal disease. This article reviews the emerging molecular subtypes of mCRPC that are driving the evolution of mCRPC treatment.

New Treatments for Men with Castration-resistant Prostate Cancer: Can We Move from Small Steps to Giant Leaps?

European Urology ◽

10.1016/j.eururo.2013.08.059 ◽

2014 ◽

Vol 65 (2) ◽

pp. 300-302 ◽

Cited By ~ 2

Author(s):

Andrew J. Armstrong

Keyword(s):

Prostate Cancer ◽

Castration Resistant ◽

LSD1 activates a lethal prostate cancer gene network independently of its demethylase function

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1719168115 ◽

2018 ◽

Vol 115 (18) ◽

pp. E4179-E4188 ◽

Cited By ~ 56

Author(s):

Archana Sehrawat ◽

Lina Gao ◽

Yuliang Wang ◽

Armand Bankhead ◽

Shannon K. McWeeney ◽

...

Keyword(s):

Prostate Cancer ◽

Gene Network ◽

Resistance Mechanisms ◽

Cancer Gene ◽

Castration Resistant ◽

Lysine Specific Demethylase ◽

Independent Functions ◽

New Treatments ◽

Lethal Prostate Cancer

Medical castration that interferes with androgen receptor (AR) function is the principal treatment for advanced prostate cancer. However, clinical progression is universal, and tumors with AR-independent resistance mechanisms appear to be increasing in frequency. Consequently, there is an urgent need to develop new treatments targeting molecular pathways enriched in lethal prostate cancer. Lysine-specific demethylase 1 (LSD1) is a histone demethylase and an important regulator of gene expression. Here, we show that LSD1 promotes the survival of prostate cancer cells, including those that are castration-resistant, independently of its demethylase function and of the AR. Importantly, this effect is explained in part by activation of a lethal prostate cancer gene network in collaboration with LSD1’s binding protein, ZNF217. Finally, that a small-molecule LSD1 inhibitor―SP-2509―blocks important demethylase-independent functions and suppresses castration-resistant prostate cancer cell viability demonstrates the potential of LSD1 inhibition in this disease.

PCN72 Cost Effectiveness Analysis of New Treatments for Metastatic Castration-Resistant Prostate Cancer: Does Severity Matter?

Value in Health ◽

10.1016/j.jval.2012.03.1189 ◽

2012 ◽

Vol 15 (4) ◽

pp. A220-A221 ◽

Cited By ~ 1

Author(s):

L.S. Wilson ◽

L. Zhong ◽

V. Pon ◽

S. Srinivas ◽

M. Frear ◽

...

Keyword(s):

Prostate Cancer ◽

Cost Effectiveness ◽

Cost Effectiveness Analysis ◽

Castration Resistant ◽

Effectiveness Analysis ◽

Castration-Resistant Prostate Cancer: Mechanisms, Targets, and Treatment

Prostate Cancer ◽

10.1155/2012/327253 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 51

Author(s):

Teresa Maria Santos Amaral ◽

Daniela Macedo ◽

Isabel Fernandes ◽

Luis Costa

Keyword(s):

Prostate Cancer ◽

Clinical Trials ◽

New Drugs ◽

Rational Approach ◽

Cancer Resistance ◽

Castration Resistant ◽

Great Investment ◽

New Treatments ◽

Chemotherapy Agents

Patients with castration-resistant prostate cancer (CRPC), who progress after docetaxel therapy, had until very recently, only a few therapeutic options. Recent advances in this field brought about new perspectives in the treatment of this disease. Molecular, basic, and translational research has given us a better understanding on the mechanisms of CRPC. This great investment has turned into a more rational approach to the development of new drugs. Some of the new treatments are already available to our patients outside clinical trials and may include inhibitors of androgen biosynthesis; new chemotherapy agents; bone-targeted therapy; and immunotherapy. This paper aims to review the mechanisms of prostate cancer resistance, possible therapeutic targets, as well as new options to treat CRPC.