Novel targeted therapies for prostate cancer

This article reviews the concepts and rationale behind targeted agents that are currently in clinical testing for patients with castration resistant prostate cancer (CRPC). Advances in our understanding of the molecular mechanisms underlying prostate cancer progression has translated into a variety of treatment approaches. Agents targeting androgen receptor activation and local steroidogenesis, angiogenesis, apoptosis, chaperone proteins, the insulinlike growth factor pathway, RANK ligand, endothelin receptors, and Src family kinases are entering, or have recently completed, accrual to phase III trials for patients with CRPC. There has also been interest generated by data from early-phase studies evaluating multitargeted tyrosine kinase inhibitors, agents effecting signal transduction pathways, and novel cytotoxics.

Satraplatin for the therapy of castration-resistant prostate cancer

While docetaxel-based chemotherapy improves survival in patients with castration-resistant prostate cancer, all of these patient’s cancers will eventually progress and other active treatment agents are necessary. Satraplatin is a third-generation orally-available platinum analog that demonstrated a 33% reduction in the risk of progression in patients with metastatic castration-resistant prostate cancer following one prior chemotherapy regimen in the large Phase III Satraplatin and Prednisone Against Refractory Cancer (SPARC) trial. Satraplatin also demonstrated beneficial effects on pain and displayed evidence of biological activity with prostate-specific antigen level declines and objective response rates. Satraplatin did not significantly extend survival, although this analysis may have been confounded by post-study therapy. Further development is ongoing with the evaluation of combination regimens containing satraplatin in other solid tumors. In addition, efforts are ongoing to select patients who are more likely to benefit from satraplatin.