Update of the most recent advances in the treatment of metastatic castration-resistant prostate cancer

Most men with advanced prostate cancer initially respond to androgen deprivation therapy (ADT) but eventually develop metastatic castration-resistant prostate cancer (CRPC). Over the last decade, the understanding of the underlying biology of CRPC has heralded a new era in molecular-targeted anticancer drug development, with many novel drugs for CRPC entering the clinic. Before 2010, docetaxel-based chemotherapy had been the only treatment of CRPC that improved overall survival in patients. In the recent two years, several new drugs appeared including the novel inhibitor of the androgen receptor (MDV3100), the CYP17 inhibitor (Abiraterone acetate, TAK-700), immunotherapies (sipuleucel-T), the novel chemotherapy (cabazitaxel, OGX-011), bonetargeted drugs (denosumab, Alpharadin), radio-isotope therapy (Metastron, Quadramet) and endothelin receptor antagonists (atrasentan, zibotentan) capable of improving the prognosis of the patients with CRPC. Here, we review the most recent advances in the treatment of metastatic CRPC and highlight the most promising new agents currently being investigated in clinical trials.