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Second‐line therapy for castrate‐resistant prostate cancer: A literature review

Despite a survival benefit in the first‐line treatment of castrate‐resistant prostate cancer (CRPC) with docetaxel, the prognosis remains limited. There are increasing options available for patients with CRPC in the second‐line setting, but there is currently little consensus regarding the optimal treatment. There have been numerous phase II and retrospective studies examining second‐line options in CRPC, including retreatment with docetaxel, mitoxantrone, cyclophosphamide and carboplatin, which can be associated with meaningful responses in a significant minority of patients. In 2010 three randomized trials were published or presented which demonstrated a survival benefit in the second‐line setting. These included cabazitaxel compared with mitoxantrone, sipuleucel‐T (immunotherapy) and abiraterone acetate versus placebo. Ongoing research in the second‐line setting of CRPC to optimize treatment options, with the objectives of survival prolongation, improvement in quality of life and pain management, is still needed.