Castration-resistant prostate cancer (CRPC) has a poor prognosis: current chemotherapeutic approaches ultimately result in resistance and are associated with survival rates of less than 2 years. However, the last decade has seen an expansion in the number of therapeutic options for CRPC and the regulatory approval of several agents, including the chemotherapy drug cabazitaxel and the targeted agents abiraterone acetate, enzalatumide, and denosumab. Novel targeted agents inhibit androgen receptor-mediated signaling, and nonhormonal targets, including apoptosis, signal transduction pathway inhibitors, angiogenesis, and bone and immune microenvironments. Clinical trials of these agents, however, have demonstrated varied efficacy. Among the drugs in clinical development, custirsen, cabozantinib, and dasatinib are among the most promising. There is a requirement for studies directly comparing agents, and for improved patient selection to identify patients benefitting from a particular therapy.
Molecular Targets for Radiation Oncology in Prostate Cancer
