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Targeted Therapies and Vaccination

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Management of Prostate Cancer

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Abstract

Multiple emerging agents and paradigm changing advances in the management of castration-resistant prostate cancer (CRPC) have occurred since 2010. Three novel antitumor agents and a two bone health-enhancing agents have demonstrated improved outcomes in metastatic CRPC. Cabazitaxel, a novel taxane, extended survival in men with progressive metastatic CRPC (mCRPC) following conventional docetaxel-based chemotherapy. Sipuleucel-T, an autologous dendritic-cell-based vaccine, extended survival in men with relatively asymptomatic mCRPC without visceral metastasis. Abiraterone acetate, an orally administered CYP17 inhibitor, which suppresses androgen synthesis significantly, prolonged survival following prior docetaxel. A phase III trial demonstrated the superiority of denosumab, a RANK-ligand antagonist, compared to zoledronic acid in the prevention of skeletal-related events in patients with bone metastases. A novel radiopharmaceutical agent, Ra223, was preliminarily reported to extend survival in patients with symptomatic bone metastases, and MDV3100, an androgen receptor antagonist was preliminarily reported to extend survival following prior docetaxel-based therapy. Multiple other androgen pathway antagonists (TAK700 MDV3100), immunotherapeutic agents (ipilimumab), and biologic agents (cabozantinib, tasquinimod, lenalidomide) are undergoing vigorous investigation based on promising preliminary activity. An emerging focus on the development of optimal sequencing, tolerable combinations, as well as molecular markers to optimally select patients is urgently needed.

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Disclosures

• Cora N. Sternberg: research support from Cougar Biotech, Medivation, Celgene, Sanofi-Aventis, and Pfizer

• Guru Sonpavde: research support from Eli Lilly, BMS, Pfizer, Novartis, Cephalon, Celgene, and Astrazeneca and speakers’ bureau or advisory boards for Pfizer, BMS, Novartis, GSK, Wyeth, and Sanofi-Aventis

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Authors and Affiliations

  1. Texas Oncology and the Veterans Affairs Medical Center, Baylor College of Medicine, 501 Medical Center Blvd, Webster, TX, 77598, USA

    Guru Sonpavde M.D.

  2. San Camillo and Forlanini Hospitals, Padiglione Flajani, Circonvallazione Gianicolense 87, 00152, Rome, Italy

    Cora N. Sternberg M.D., FACP

Authors
  1. Guru Sonpavde M.D.
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  2. Cora N. Sternberg M.D., FACP
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Corresponding author

Correspondence to Cora N. Sternberg M.D., FACP .

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Editors and Affiliations

  1. , Department of Oncology and Radiotherapy, University Hospital, BP 217X, Grenoble, 38043, France

    Michel Bolla

  2. , Department of Urology, University Hospital, Herestraat 49, Leuven, 3000, Belgium

    Hendrik van Poppel

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© 2012 Springer-Verlag Berlin Heidelberg

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Sonpavde, G., Sternberg, C.N. (2012). Targeted Therapies and Vaccination. In: Bolla, M., van Poppel, H. (eds) Management of Prostate Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27597-5_20

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  • DOI: https://doi.org/10.1007/978-3-642-27597-5_20

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  • Online ISBN: 978-3-642-27597-5

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