Target therapy of hormone-resistant prostate cancer

Hormone therapy (HT) for prostate cancer (PCa) is the first line drug therapy for metastatic prostate cancer. The time between the onset of hormonal medications and the development of hormone-resistance is about 12-18 months, with 15-20% of patients with tumor primary resistant to HT. As a second-line chemotherapy various schemes with cytotoxic drugs have been proposed: mitoxantrone + prednisone, estramustine, estramustine + vinblastine, or vinorelbine +. Large randomized trials have proved schemes including docetaxel to be most efficient. Thus the scheme of docetaxel + prednisone becomes the standard. Experimental studies have shown the effect of angiogenesis on the development of prostate cancer. There was an attempt to overcome resistance by metronomic therapy, based on the antiangiogenic rather than cytotoxic effect of the drug. The most modern approach is to use target therapy due to the the use of angiogenesis inhibitors (eg sunitinib). Schemes of sunitinib monotherapy or in combination with low-dose and high-dose chemotherapy with docetaxel were reviewed. Preclinical and clinical results have shown a positive effect, which makes the hormone target therapy for prostate cancer one of the most promising options. Currently, target therapy may be considered as second-line treatment after failure of docetaxel therapy. The development of optimal treatment scheme is a matter of further research.