Is it Time to Change the Control Placebo Arms in Phase III Trials of Metastatic Castration Resistant Prostate Cancer?

  • Dogan, Mutlu (Dept. of Medical Oncology, Ankara Numune Training and Research Hospital) ;
  • Erdem, Gokmen Umut (Dept. of Medical Oncology, Ankara Numune Training and Research Hospital) ;
  • Zengin, Nurullah (Dept. of Medical Oncology, Ankara Numune Training and Research Hospital)
  • Published : 2015.09.02


Prostate cancer is common all around the world. Hormonal therapy is the mainstay of therapy, however castration-resistant prostate cancer (CRPC) becomes a serious problem and needs further clinical trials with novel agents. Novel agents like cabazitaxel, abireterone acetate or enzalutamide are encouraging but we do not know which one is the best in metastatic CRPC. In here, treatment modalities for metastatic CRPC are discussed witha mini-review of the literature.


  1. Beer TM, Armstrong AJ, Rathkopf DE, et al (2014). Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med, 371, 424-33.
  2. de Bono JS, Logothetis CJ, Molina A, et al (2011). Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med, 364, 1995-2005.
  3. de Bono JS, Oudard S, Ozguroglu M, et al (2010). Prednisone plus cabazitaxel or mitoxantrone for metastatic castrationresistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet, 376, 1147-54.
  4. Efstathiou E, Titus MA, Wen S et al (2014) Enzalutamide (ENZA) in combination with abiraterone acetate (AA) in bone metastatic castration resistant prostate cancer (mCRPC). J Clin Oncol, 32, 5000.
  5. Iranikhah M, Stricker S, Freeman MK (2014). Future of bisphosphonates and denosumab for men with advanced prostate cancer. Cancer Manag Res, 6, 217-24.
  6. Lee JL, Park SH, Koh SJ, et al (2014). Effectiveness and safety of cabazitaxel plus prednisolone chemotherapy for metastatic castration-resistant prostatic carcinoma: data on Korean patients obtained by the cabazitaxel compassionate-use program. Cancer Chemother Pharmacol. [Epub ahead of print].
  7. Scher HI, Fizazi K, Saad F, et al (2012). Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med, 367, 1187-97.
  8. Tan PS, Haaland B, Montero AJ, et al (2014). Hormonal therapeutics enzalutamide and abiraterone acetate in the treatment of metastatic castration-resistant prostate cancer (mCRPC) Post-docetaxel-an Indirect Comparison. Clin Med Insights Oncol, 8, 29-36.
  9. Zhou ZR, Liu SX, Zhang TS, et al (2014). Abiraterone for treatment of metastatic castration-resistant prostate cancer: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 15, 1313-20.