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. |  |  |