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Table 1 Newly approved hormonal agents for the treatment of mCRPC

From: Changing paradigms in management of metastatic Castration Resistant Prostate Cancer (mCRPC)

Drug Date of FDA approval and indication Mechanism of action Side effects
Abiraterone acetate (Zytiga) December2012- (COU-AA-301) An androgen biosynthesis inhibitor of 17 alpha hydroxylase/C-17,20-lyase within prostate cancer cells and outside Fatigue, joint swelling, edema, hot flashes, diarrhea, cough.
In combination with prednisone for treatment of patients in mCRPC [29]
Administration of prednisone is necessary to overcome hypertension, hypokalemia, fluid overload from mineralocorticoid excess induced by CYP17-inhibition
April 2012- (COU-AA-302) [30]
Treatment of mCRPC in patients with have received prior chemotherapy containing Docetaxel
Enzalutamide (Xtandi) Previously known as MDV3100 August 2012- AFFIRM trial [34] Androgen receptor inhibitor- inhibits multiple steps in AR signaling Fatigue, hot flashes, musculoskeletal pain, hyperglycemia, weight gain, Seizures in 0.6% of the patients.
Monotherapy for mCRPC who have previously received Docetaxel
January 2014- PREVAIL trial [35]
  Survival benefit in chemotherapy naïve patients. Awaiting FDA approval.