Current possibilities and view of treatment of castration refractory metastatic prostate cancer

Prostate cancer is currently known as the most common cancer and the second leading cause of death from cancer in men in Western population. Advanced prostate cancer is initially sensitive to androgen-deprivation therapy (ADT) but later on progresses to castration resistant state. Understanding the mechanisms that transform prostate cancer (PCA) into a castration-resistant state enables investigators to explore suppression of extraresticular androgens and other critical pathways to suggest appropriate and rational therapeutic design. We have new ARTA drugs at our disposal, in patients previously treated with chemotherapy as well as for chemo naive. Chemotherapy still plays important role in selected patients. In some others specific immunotherapy appears to be effective. Some targeted drugs also have demonstrated promising activity. (author)