Second line chemotherapy in patients with castration-refractory prostate cancer. From clinical studies to practice

Prostate cancer (PC) is one of the most pressing problems of modern oncology due to high worldwide morbidity for this pathology. Annually, more than 1,100,000 new cases of PC are diagnosed worldwide. The main treatment method for patients with locally advanced and/or metastatic PC is hormone therapy. Androgen deprivation allows to achieve disease stabilization in more than 90 % of patients, but mean time to progression after hormone therapy in patients with metastatic PC is about 2 years. Patients with cancer progression and preserved castration level of testosterone transition to the stage of so-called castration-resistant prostate cancer (CRPC). Advanced CRPC not only has poor prognosis, it also significantly decreases quality of life of the patients. CRPC patient cohort is extremely heterogenous and included patients both with factors of favorable prognosis and fulminant course of the disease. Unfavorable prognostic factors for patients with metastatic CRCP are short response time for initial hormone therapy (< 12 months), presence of pain syndrome as well as presence of visceral metastases. Taxane chemotherapy remains one of the standard treatment methods in patients with metastatic CRPC and unfavorable prognostic factors. The article presents a review of studies dedicated to the effectiveness of various doses and regimens of 2nd line chemotherapy using cabazitaxel in patients with metastatic CRPC as well as analysis of clinical cases of using this drug in real-life clinical practice.