Efficacy and problems of new hormonal agents for the treatment of castration resistant prostate cancer

Enzalutamide and abiraterone acetate are novel drugs for the treatment of castration resistant prostate cancer (CRPC). These agents clearly demonstrated improvements in PFS and OS in patients with CRPC in large randomized Phase III trials. However, the problems exist such as side effects, PSA flare, treatment biomarkers and sequence of the treatment. Further research is necessary to determine the optimal sequence of the treatment or the optimal combination approach with both enzalutamide and abiraterone acetate. It is also necessary to find predictive factors (clinical or molecular) to assist the clinician in making better treatment decisions in an individualized manner.