Expanding Treatment Options for Metastatic Prostate Cancer

Prostate cancer is an androgen-receptor–dependent disease, and the blocking of androgen-receptor signaling is a hallmark of prostate-cancer therapeutics. Although most patients initially benefit from therapy involving deprivation of gonadal androgen, the disease eventually progresses after 12 to 48 months, depending on the disease burden, host factors, and inherent tumor biology. After progression, the disease evolves into a new clinically and molecularly heterogeneous state known as castration-resistant prostate cancer, which is invariably fatal.The clinical course of metastatic castration-resistant prostate cancer has changed considerably, primarily because of factors such as earlier diagnosis, stage migration, and changes in practice patterns. Earlier initiation . . .