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Table 2 Newer agents under development for the treatment of mCRPC

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

Agent Mechanism of action Phase of development Side effects Ongoing trials
Orteronel (TAK-700) Non-steroidal, selective inhibitor of 17, 20lyase, an enzyme required for androgen biosynthesis. The results of Phase III trial (ELM-PC 4) did not show any survival benefit in chemotherapy naïve patients. An improvement in rPFS was seen. Fatigue, GI toxicity RTOG and SWOG- TAK + LHRH agonist to test whether improvement in OS or not
Galeterone (TOK-001) Next generation AR antagonist and CYP17A1 inhibitor ARMOR 1- phase I study showed the drug is well tolerated [42] Fatigue, Nausea, Diarrhea ARMOR 2 is underway in 4 distinct populations
1. Metastatic and treatment naïve
2. Non metastatic and treatment naïve
3. Patients who have progressed on abiraterone
4. Patients who have progressed on enzalutamide
ARN-509 Inhibits AR translocation and AR binding to DNA, does not exhibit agonist properties in the context of AR over-expression Results from phase I studies showed that the drug is well tolerated and PSA decline at 12 weeks (>50% from the baseline) were observed in 46.7% of the patients. [38] Fatigue, nausea, pain Phase II study is underway in patients with mCRPC (NCT01171898)