Current Treatment Modalities Targeting Tumor Microenvironment in Castration-Resistant Prostate Cancer

Siddhartha Nagireddy, Rehana Qureshi, Jordan Best, Fabio Stefano Frech, Khushi Shah, Yash Soni, Manish Kuchakulla, Manish Narasimman, Himanshu Arora

Research output: Chapter in Book/Report/Conference proceedingChapter


Prostate cancer (PCa) is responsible for significant cancer-related morbidity and mortality following local treatment failure in men. The initial stages of PCa are typically managed with a combination of surgical resection and/or androgen deprivation therapy (ADT). Unfortunately, a significant proportion of PCa continues to progress despite being at castrate levels of testosterone (<50 ng/dl), at which point it is coined castration-resistant prostate cancer (CRPC). In recent years, many novel therapeutics and drug combinations have been created for CRPC patients. These include immune checkpoint inhibitors, chemokine receptor antagonists, steroidogenic enzyme inhibition, and novel tyrosine kinase inhibitors as well as combinations of drugs. The selection of the most appropriate therapy depends on several factors like stage of the disease, age of the patient, metastasis, functional status, and response towards previous therapies. Here, we review the current state of the literature regarding treatment modalities, focusing on the treatment recommendations per the American Urological Association (AUA), recent clinical trials, and their limitations. An accurate and reliable overview of the strengths and limitations of PCa therapeutics could also allow personalized therapeutic interventions against PCa.

Original languageEnglish (US)
Title of host publicationAdvances in Experimental Medicine and Biology
Number of pages29
StatePublished - 2021

Publication series

NameAdvances in Experimental Medicine and Biology
ISSN (Print)0065-2598
ISSN (Electronic)2214-8019


  • Androgen deprivation therapy
  • Asymptomatic mCRPC
  • Chemokine receptor antagonists
  • CRPC
  • CRPC treatment
  • Immune checkpoint inhibitors
  • Immunotherapy
  • Prostate cancer
  • Secondary hormonal manipulations
  • Steroidogenic enzyme inhibition
  • Symptomatic mCRPC
  • Tumor microenvironment
  • Tumor-associated macrophages
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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