Emerging agents for the therapy of advanced prostate cancer.

Since 2010, multiple advances have been made in the field of metastatic castration-resistant prostate cancer including regulatory approvals for five new agents including androgen pathway inhibitors (enzalutamide, abiraterone acetate), immunotherapy (sipuleucel-T), cytotoxic chemotherapy (cabazitaxel) and radiopharmaceuticals (radium-223) that have improved overall survival in this patient population. Despite these advances, each therapy has only extended median survival by 3-5 months and data suggest substantial cross-resistance among them. Given these modest increments, there is a major role for the vigorous investigation of new drugs and predictive biomarkers to select suitable patients who will benefit from them.