# Metastatic castration-resistant prostate cancer

Source: https://onco.cc/cancers/prostate-mcrpc/  
OnCo record `prostate-mcrpc` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Metastatic castration-resistant prostate cancer is disease that grows despite castrate testosterone. Sequenced treatments now include androgen receptor inhibitors, docetaxel and cabazitaxel, PARP inhibitors for men with BRCA-type mutations, the radioligand 177Lu-PSMA-617 and radium-223 for bone-predominant disease.

## Summary

Metastatic castration-resistant prostate cancer is defined by progression on scans or PSA, or new metastases, with castrate testosterone. Nearly every man reaches it from hormone-sensitive disease, and the treatment chosen depends on what he has already had. Men who have not had an androgen receptor pathway inhibitor receive abiraterone or enzalutamide; PROpel, TALAPRO-2 and MAGNITUDE showed that adding olaparib, talazoparib or niraparib helps men with BRCA and other homologous recombination repair mutations, and PROfound showed olaparib alone beats a second hormonal agent in these men. Docetaxel and then cabazitaxel remain the chemotherapies. VISION established 177Lu-PSMA-617 after chemotherapy and PSMAfore moved it before, for PSMA PET-positive disease; 177Lu-PSMA-I&T (SPLASH, ECLIPSE) follows the same path. Radium-223 lengthens life in symptomatic bone-predominant disease without visceral metastases (ALSYMPCA), sipuleucel-T is still approved for minimally symptomatic disease, and pembrolizumab is used for the rare mismatch repair-deficient tumour. Tumour and germline testing for HRR genes and mismatch repair is standard. Actinium-225 PSMA agents, the STEAP1 T-cell engager xaluritamig and the EZH2 inhibitor mevrometostat are in phase 3.

## Fields

- Kind: Cancer
- Last checked: 2026-09-25
- Also known as: mCRPC; Metastatic CRPC; Castration-resistant metastatic prostate cancer; Hormone-refractory prostate cancer (older term); Hormone-relapsed metastatic prostate cancer; Hormone-refractory prostate cancer
- Tags: subtype-page
- Group: genitourinary
- Burden: The state in which nearly all prostate cancer deaths occur, about 400,000 a year worldwide; median survival from first treatment is now around three years, longer for men who have not had an androgen receptor inhibitor.
- Subtypes: mCRPC, androgen receptor pathway inhibitor-naive; mCRPC after an androgen receptor pathway inhibitor, chemotherapy-naive; mCRPC after taxane chemotherapy; HRR-mutant mCRPC (BRCA1, BRCA2, ATM and others; PARP inhibitors); PSMA PET-positive mCRPC (radioligand therapy); Bone-predominant mCRPC without visceral metastases (radium-223); Mismatch repair-deficient mCRPC (pembrolizumab)
- Biomarkers: Tumour and germline HRR genes (BRCA2 above all); PSMA PET uptake and FDG discordance; Mismatch repair deficiency and tumour mutational burden; PSA and alkaline phosphatase; Circulating tumour DNA (AR amplification, BRCA2 reversion); AR-V7 in circulating tumour cells (research)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/prostate-mcrpc/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/prostate-mcrpc/#overview [3 state-of-the-art points]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/prostate-mcrpc/#what-it-is [7 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/prostate-mcrpc/#finding-it [6 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/prostate-mcrpc/#treating-it [5 settings, 5 decisions with options]
- Trials and papers (own page): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/prostate-mcrpc/evidence/ [103 trials, 55 key papers, 10 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/prostate-mcrpc/#science [15 targets, 1 pathway]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/prostate-mcrpc/where-you-are/ [2 centres, 26 UK centres]
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/prostate-mcrpc/#living-with-it [23 questions, 6 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/prostate-mcrpc/coming/ [32 medicines, 103 trials, 4 ideas, 4 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/prostate-mcrpc/data/ [290 connected records, 1 note]

## Standard of care

- First line, androgen receptor pathway inhibitor-naive: Abiraterone or enzalutamide; add olaparib, talazoparib or niraparib for HRR-mutant, above all BRCA-mutant, disease (PROpel, TALAPRO-2, MAGNITUDE). ([Abiraterone acetate](https://onco.cc/drugs/abiraterone/), [Enzalutamide](https://onco.cc/drugs/enzalutamide/), [Olaparib](https://onco.cc/drugs/olaparib/), [Talazoparib](https://onco.cc/drugs/talazoparib/), [Niraparib](https://onco.cc/drugs/niraparib/), [PROpel](https://onco.cc/trials/propel/), [TALAPRO-2](https://onco.cc/trials/talapro-2/), [MAGNITUDE](https://onco.cc/trials/magnitude/))
- After an androgen receptor pathway inhibitor: Docetaxel; olaparib or rucaparib for BRCA-mutant disease (PROfound); 177Lu-PSMA-617 for PSMA-positive disease before chemotherapy (PSMAfore); pembrolizumab for mismatch repair-deficient tumours. ([Docetaxel](https://onco.cc/drugs/docetaxel/), [Olaparib](https://onco.cc/drugs/olaparib/), [Rucaparib](https://onco.cc/drugs/rucaparib/), [PROfound](https://onco.cc/trials/profound/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [PSMAfore](https://onco.cc/trials/psmafore/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/))
- After docetaxel: 177Lu-PSMA-617 (VISION), cabazitaxel, radium-223 for symptomatic bone-only disease (ALSYMPCA), or a PARP inhibitor if not yet used. ([Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [VISION](https://onco.cc/trials/vision/), [Cabazitaxel](https://onco.cc/drugs/cabazitaxel/), [Radium-223 dichloride](https://onco.cc/drugs/radium-223/), [ALSYMPCA](https://onco.cc/trials/alsympca/), [TheraP (ANZUP 1603)](https://onco.cc/trials/therap/))
- Bone health: Denosumab or zoledronic acid to prevent skeletal events, with calcium and vitamin D; palliative radiotherapy to painful metastases. ([Denosumab](https://onco.cc/drugs/denosumab/), [Zoledronic acid](https://onco.cc/drugs/zoledronic-acid/), [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/))
- Phase 3 options: Actinium-225 PSMA radioligands, the STEAP1 T-cell engager xaluritamig, the EZH2 inhibitor mevrometostat and 177Lu-PSMA-I&T within trials. ([Actinium-225 PSMA agents](https://onco.cc/drugs/ac225-psma/), [Xaluritamig](https://onco.cc/drugs/xaluritamig/), [Mevrometostat](https://onco.cc/drugs/mevrometostat/), [177Lu-PSMA-I&T](https://onco.cc/drugs/lu177-psma-it/), [AlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)](https://onco.cc/trials/alphabreak/), [XALute](https://onco.cc/trials/xalute/), [MEVPRO-1](https://onco.cc/trials/mevpro-1/), [SPLASH](https://onco.cc/trials/splash/), [ECLIPSE](https://onco.cc/trials/eclipse-psma/))

## State of the art

- PSMA PET and 177Lu-PSMA-617 make prostate cancer the model for theranostics.
- PARP inhibitors gave prostate cancer its first genotype-directed treatment.
- Survival in this once six-month setting is now measured in years, built from sequenced drugs rather than one breakthrough.

## Open problems

- The best sequence of radioligand, PARP inhibitor and chemotherapy is untested.
- Actinium-225 supply and the lack of alpha-emitter dosimetry.
- Lineage plasticity to neuroendocrine disease under androgen receptor blockade.
- Resistance to 177Lu-PSMA-617 in PSMA-low or FDG-discordant disease.

## Notes

- NICE calls this hormone-relapsed metastatic prostate cancer, which is the heading its own recommendations use; castration-resistant is the term of the trials, the labels and the American guidelines. A British patient will meet both words for the same disease.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Castration-resistant_prostate_cancer
- Wikipedia: https://en.wikipedia.org/wiki/Castration-resistant_prostate_cancer
- NCCN Guidelines: Prostate Cancer: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459
- NICE NG131: prostate cancer, diagnosis and management (recommendations, including the Cambridge Prognostic Group table at 1.2.15): https://www.nice.org.uk/guidance/ng131/chapter/Recommendations

## Connected records

- cancers: [Biochemical recurrence of prostate cancer](https://onco.cc/cancers/prostate-bcr/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Neuroendocrine and small-cell prostate cancer](https://onco.cc/cancers/prostate-nepc/), [Non-metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-nmcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- terms: [AR-V7 splice variant](https://onco.cc/terms/ar-v7/), [Bipolar androgen therapy (BAT)](https://onco.cc/terms/bipolar-androgen-therapy/), [BRCA reversion mutations](https://onco.cc/terms/brca-reversion-mutations/), [Castration-resistant prostate cancer (CRPC)](https://onco.cc/terms/castration-resistance/), [Chromoplexy](https://onco.cc/terms/chromoplexy/), [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Genome-wide loss of heterozygosity (gLOH)](https://onco.cc/terms/genome-wide-loss-of-heterozygosity/), [Germline BRCA mutation (gBRCA)](https://onco.cc/terms/gbrca-mutation/), [Germline vs somatic mutations](https://onco.cc/terms/germline-vs-somatic/), [Histologic transformation](https://onco.cc/terms/histologic-transformation/), [Homologous recombination deficiency (HRD)](https://onco.cc/terms/hrd/), [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/), [Neuroendocrine differentiation in prostate cancer](https://onco.cc/terms/neuroendocrine-differentiation/), [Prostate cancer drugs in England: what NICE recommends, and what it refuses](https://onco.cc/terms/prostate-uk-drug-approvals/), [Prostate cancer programmes that failed, and what each failure taught](https://onco.cc/terms/prostate-failed-programmes/), [PSA kinetics: PSA doubling time and PSA density](https://onco.cc/terms/psa-kinetics/), [PTEN loss](https://onco.cc/terms/pten-loss/), [Radiographic progression-free survival (rPFS)](https://onco.cc/terms/radiographic-progression-free-survival/), [TNM staging for prostate cancer, and what changed in the 9th edition](https://onco.cc/terms/tnm-prostate-cancer/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/), [Who is eligible for a PARP inhibitor in prostate cancer, and why the gene matters](https://onco.cc/terms/prostate-hrr-eligibility/)
- key papers: [[ 177 Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial](https://onco.cc/key-papers/paper-therap-lancet-2021/), [Abiraterone in metastatic prostate cancer without previous chemotherapy](https://onco.cc/key-papers/paper-abiraterone-acetate-prostate-n-engl-j-med-2013/), [AFFIRM: increased survival with enzalutamide in prostate cancer after chemotherapy](https://onco.cc/key-papers/paper-scher-affirm-enzalutamide-nejm-2012/), [ALSYMPCA: alpha emitter radium-223 and survival in metastatic prostate cancer with bone metastases](https://onco.cc/key-papers/paper-alsympca-radium-223-nejm-2013/), [Analysis of circulating cell-free DNA identifies multiclonal heterogeneity of BRCA2 reversion mutations associated with resistance to PARP inhibitors](https://onco.cc/key-papers/paper-quigley-brca2-reversion-cfdna-parp-resistance-cancer-discov-2017/), [Androgen receptor pathway-independent prostate cancer is sustained through FGF signalling](https://onco.cc/key-papers/paper-bluemn-double-negative-prostate-fgf-mapk-cancer-cell-2017/), [AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer](https://onco.cc/key-papers/paper-antonarakis-ar-v7-resistance-nejm-2014/), [Association of clonal haematopoiesis in DNA repair genes with prostate cancer plasma cell-free DNA testing interference](https://onco.cc/key-papers/paper-jensen-clonal-haematopoiesis-cfdna-interference-prostate-jama-oncol-2021/), [Circulating tumour DNA genomics correlate with resistance to abiraterone and enzalutamide in prostate cancer](https://onco.cc/key-papers/paper-annala-ctdna-resistance-abiraterone-enzalutamide-cancer-discov-2018/), [Combined tumour suppressor defects characterise clinically defined aggressive variant prostate cancers](https://onco.cc/key-papers/paper-aparicio-aggressive-variant-prostate-tumour-suppressors-ccr-2016/), [Complex MSH2 and MSH6 mutations in hypermutated microsatellite unstable advanced prostate cancer](https://onco.cc/key-papers/paper-pritchard-complex-msh2-msh6-hypermutated-prostate-nat-commun-2014/), [Concordance of circulating tumour DNA and matched metastatic tissue biopsy in prostate cancer](https://onco.cc/key-papers/paper-wyatt-ctdna-tissue-concordance-mcrpc-jnci-2017/), [COU-AA-301: abiraterone and increased survival in metastatic castration-resistant prostate cancer after docetaxel](https://onco.cc/key-papers/paper-cou-aa-301-abiraterone-de-bono-nejm-2011/), [Detecting neuroendocrine prostate cancer through tissue-informed cell-free DNA methylation analysis](https://onco.cc/key-papers/paper-berchuck-cfdna-methylation-nepc-detection-ccr-2022/), [Divergent clonal evolution of castration-resistant neuroendocrine prostate cancer](https://onco.cc/key-papers/paper-beltran-nepc-divergent-evolution-nat-med-2016/), [Genomic analysis of circulating tumour DNA in 3,334 patients with advanced prostate cancer identifies targetable BRCA alterations and AR resistance mechanisms](https://onco.cc/key-papers/paper-tukachinsky-ctdna-3334-advanced-prostate-ccr-2021/), [Genomic correlates of clinical outcome in advanced prostate cancer](https://onco.cc/key-papers/paper-abida-genomic-correlates-outcome-mcrpc-pnas-2019/), [Genomic hallmarks and structural variation in metastatic prostate cancer](https://onco.cc/key-papers/paper-quigley-structural-variation-mcrpc-cell-2018/), [Genomics of lethal prostate cancer at diagnosis and castration resistance](https://onco.cc/key-papers/paper-mateo-genomics-lethal-prostate-diagnosis-castration-resistance-jci-2020/), [Huggins and Hodges 1941: the effect of castration, of oestrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate](https://onco.cc/key-papers/paper-huggins-hodges-castration-serum-phosphatases-prostate-1941/), [In vivo amplification of the androgen receptor gene and progression of human prostate cancer](https://onco.cc/key-papers/paper-visakorpi-androgen-receptor-amplification-nat-genet-1995/), [Inherited DNA-repair gene mutations in men with metastatic prostate cancer](https://onco.cc/key-papers/paper-pritchard-inherited-dna-repair-metastatic-prostate-nejm-2016/), [Intraductal and ductal histology and lymphovascular invasion are associated with germline DNA-repair gene mutations in prostate cancer](https://onco.cc/key-papers/paper-isaacsson-velho-intraductal-germline-dna-repair-prostate-2018/), [IPATential150: ipatasertib plus abiraterone and prednisolone in metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-ipatential150-ipatasertib-abiraterone-pten-lancet-2021/), [KEYNOTE-199: pembrolizumab for treatment-refractory metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-antonarakis-keynote-199-pembrolizumab-jco-2020/), [Molecular determinants of resistance to antiandrogen therapy](https://onco.cc/key-papers/paper-chen-androgen-receptor-overexpression-antiandrogen-resistance-nat-med-2004/), [Molecular profiling stratifies diverse phenotypes of treatment-refractory metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-labrecque-mcrpc-phenotypes-jci-2019/), [Mutation of the androgen-receptor gene in metastatic androgen-independent prostate cancer](https://onco.cc/key-papers/paper-taplin-ar-mutation-androgen-independent-prostate-nejm-1995/), [Nuclear-localised androgen receptor splice variant 7 in circulating tumour cells as a predictive biomarker in castration-resistant prostate cancer](https://onco.cc/key-papers/paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018/), [Phase 1 trial of abiraterone acetate confirms that castration-resistant prostate cancer commonly remains hormone driven](https://onco.cc/key-papers/paper-attard-abiraterone-phase-1-cyp17-jco-2008/), [PREVAIL: enzalutamide in metastatic prostate cancer before chemotherapy](https://onco.cc/key-papers/paper-beer-prevail-enzalutamide-nejm-2014/), [Prevalence of microsatellite instability in prostate cancer and response to immune checkpoint blockade](https://onco.cc/key-papers/paper-abida-msi-prostate-checkpoint-blockade-jama-oncol-2019/), [PROfound: olaparib for metastatic castration-resistant prostate cancer with homologous recombination repair gene alterations](https://onco.cc/key-papers/paper-profound-nejm-2020/), [PROPHECY: prospective multicentre validation of androgen receptor splice variant 7 and hormone therapy resistance in high-risk castration-resistant prostate cancer](https://onco.cc/key-papers/paper-prophecy-arv7-validation-jco-2019/), [Prospective comprehensive genomic profiling of 3,476 primary and metastatic prostate tumours](https://onco.cc/key-papers/paper-chung-comprehensive-genomic-profiling-prostate-jco-po-2019/), [Prostate-specific membrane antigen expression in normal and malignant human tissues](https://onco.cc/key-papers/paper-silver-psma-expression-normal-malignant-tissues-ccr-1997/), [PTEN protein loss and clinical outcome from castration-resistant prostate cancer treated with abiraterone acetate](https://onco.cc/key-papers/paper-ferraldeschi-pten-protein-loss-abiraterone-eur-urol-2015/), [Rb1 and Trp53 cooperate to suppress prostate cancer lineage plasticity, metastasis and antiandrogen resistance](https://onco.cc/key-papers/paper-ku-rb1-trp53-lineage-plasticity-science-2017/), [Reciprocal feedback regulation of PI3K and androgen receptor signalling in PTEN-deficient prostate cancer](https://onco.cc/key-papers/paper-carver-pi3k-ar-reciprocal-feedback-prostate-cancer-cell-2011/), [Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer](https://onco.cc/key-papers/paper-tomlins-tmprss2-ets-fusion-science-2005/), [RESTORE: bipolar androgen therapy after progression on enzalutamide in metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-teply-restore-bipolar-androgen-therapy-lancet-oncol-2018/), [SOX2 promotes lineage plasticity and antiandrogen resistance in TP53- and RB1-deficient prostate cancer](https://onco.cc/key-papers/paper-mu-sox2-lineage-plasticity-science-2017/), [SU2C-PCF: integrative clinical genomics of advanced prostate cancer](https://onco.cc/key-papers/paper-robinson-integrative-clinical-genomics-advanced-prostate-cell-2015/), [Substantial interindividual and limited intraindividual genomic diversity among tumours from men with metastatic prostate cancer](https://onco.cc/key-papers/paper-kumar-interindividual-genomic-diversity-metastatic-prostate-nat-med-2016/), [SWOG 9916: docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer](https://onco.cc/key-papers/paper-petrylak-swog-9916-docetaxel-estramustine-nejm-2004/), [TAX 327: docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer](https://onco.cc/key-papers/paper-tannock-tax-327-docetaxel-prednisone-nejm-2004/), [The evolutionary history of lethal metastatic prostate cancer](https://onco.cc/key-papers/paper-gundem-evolutionary-history-lethal-metastatic-prostate-nature-2015/), [The long tail of oncogenic drivers in prostate cancer](https://onco.cc/key-papers/paper-armenia-long-tail-oncogenic-drivers-prostate-nat-genet-2018/), [The mutational landscape of lethal castration-resistant prostate cancer](https://onco.cc/key-papers/paper-grasso-mutational-landscape-lethal-crpc-nature-2012/), [TOPARP-A: DNA-repair defects and olaparib in metastatic prostate cancer](https://onco.cc/key-papers/paper-mateo-toparp-a-olaparib-dna-repair-nejm-2015/), [TRANSFORMER: bipolar androgen therapy versus enzalutamide in asymptomatic metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-denmeade-transformer-bipolar-androgen-therapy-jco-2021/), [TRITON2: rucaparib in men with metastatic castration-resistant prostate cancer harbouring a BRCA1 or BRCA2 alteration](https://onco.cc/key-papers/paper-abida-triton2-rucaparib-brca-jco-2020/), [TRITON3: rucaparib or physician's choice in metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-fizazi-triton3-rucaparib-nejm-2023/), [TROPIC: prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel](https://onco.cc/key-papers/paper-de-bono-tropic-cabazitaxel-lancet-2010/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)
- drugs: [177Lu-PSMA-I&T](https://onco.cc/drugs/lu177-psma-it/), [Abiraterone acetate](https://onco.cc/drugs/abiraterone/), [Actinium-225 PSMA agents](https://onco.cc/drugs/ac225-psma/), [Atrasentan](https://onco.cc/drugs/atrasentan/), [BMS-986365](https://onco.cc/drugs/bms-986365/), [Cabazitaxel](https://onco.cc/drugs/cabazitaxel/), [Custirsen](https://onco.cc/drugs/custirsen/), [Denosumab](https://onco.cc/drugs/denosumab/), [Docetaxel](https://onco.cc/drugs/docetaxel/), [Enzalutamide](https://onco.cc/drugs/enzalutamide/), [FPI-2265](https://onco.cc/drugs/fpi-2265/), [Galeterone](https://onco.cc/drugs/galeterone/), [HS-20093](https://onco.cc/drugs/hs-20093/), [Ifinatamab deruxtecan](https://onco.cc/drugs/ifinatamab-deruxtecan/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Mevrometostat](https://onco.cc/drugs/mevrometostat/), [Niraparib](https://onco.cc/drugs/niraparib/), [Olaparib](https://onco.cc/drugs/olaparib/), [Opevesostat](https://onco.cc/drugs/opevesostat/), [Orteronel](https://onco.cc/drugs/orteronel/), [Pasritamig](https://onco.cc/drugs/pasritamig/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [PROSTVAC](https://onco.cc/drugs/prostvac/), [Radium-223 dichloride](https://onco.cc/drugs/radium-223/), [Rucaparib](https://onco.cc/drugs/rucaparib/), [Saruparib](https://onco.cc/drugs/saruparib/), [Sipuleucel-T](https://onco.cc/drugs/sipuleucel-t/), [Talazoparib](https://onco.cc/drugs/talazoparib/), [Tasquinimod](https://onco.cc/drugs/tasquinimod/), [Xaluritamig](https://onco.cc/drugs/xaluritamig/), [Zibotentan](https://onco.cc/drugs/zibotentan/), [Zoledronic acid](https://onco.cc/drugs/zoledronic-acid/)
- trials: [10TASQ10](https://onco.cc/trials/tasquinimod-10tasq10/), [64Cu-SAR-bisPSMA and 67Cu-SAR-bisPSMA for Identification and Treatment of PSMA-expressing Metastatic Castrate Resistant Prostate Cancer (SECuRE)](https://onco.cc/trials/nct04868604/), [A Clinical Study of Ifinatamab Deruxtecan (I-DXd) in People With Metastatic Prostate Cancer (MK-2400-001)](https://onco.cc/trials/nct06925737/), [A Clinical Study of Ifinatamab Deruxtecan Based Treatment Combinations or as Monotherapy to Treat Metastatic Castrate Resistant Prostate Cancer (mCRPC) (MK-2400-01A/IDeate-Prostate02)](https://onco.cc/trials/nct06863272/), [A Clinical Trial Evaluating the Safety of TD001 In Patients With PSMA-Expressing Metastatic Prostate Cancer](https://onco.cc/trials/nct07258407/), [A Comparative Dose-finding Study of RS-113 in Patients With Metastatic Castration-resistant Prostate Cancer](https://onco.cc/trials/nct07553988/), [A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase III Study of Fuzuloparib Combined With Abiraterone Acetate and Prednisone (AA-P) Ver](https://onco.cc/trials/nct04691804/), [A Phase 1/2 Clinical Trial to Evaluate the Safety, Tolerability, Dosimetry, and Anti-tumor Activity of Ga-68-NGUL / Lu-177-DGUL in Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC) Refractory to Standard Therapy](https://onco.cc/trials/nct05547061/), [A Phase 1/2 Study of 177Lu-NYM032 Injection in mCRPC](https://onco.cc/trials/nct06383052/), [A Phase 1b/2a Study of Pocenbrodib as Monotherapy and in Combination With Darolutamide in Participants With mCRPC](https://onco.cc/trials/nct06785636/), [A Phase Ib/II Open-label Study of AMO959 With Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI in Adult Participants With PSMA](https://onco.cc/trials/nct07226986/), [A Phase II Study to Evaluate the Safety, Efficacy, and Pharmacokinetics of YL201 in Patients With mCRPC](https://onco.cc/trials/nct06241846/), [A Phase III Study Comparing HRS-4357 With Novel Androgen Receptor Pathway Inhibitors in Patients With Progressive, PSMA-Positive Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct07311694/), [A Phase III Trial of BNT324 Versus Docetaxel in Metastatic Castration-resistant Prostate Cancer](https://onco.cc/trials/nct07365995/), [A Study Evaluating [177Lu]Lu-PSMA-617 vs. a Change of Androgen Receptor-directed Therapy in Taxane Treatment Naive Chinese Male Patients With Progressive Metastatic Castrate Resistant Prostate Cancer](https://onco.cc/trials/nct05658003/), [A Study of Abiraterone Acetate Plus Prednisone With or Without Abemaciclib (LY2835219) in Participants With Prostate Cancer](https://onco.cc/trials/nct03706365/), [A Study of FG-3246 in Participants With Metastatic Castration-Resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct06842498/), [A Study of GSK5458514 Administered Alone or In Combination With Other Anti-Cancer Agents in Participants With Prostate Cancer](https://onco.cc/trials/nct06990880/), [A Study of JSB462 (Luxdegalutamide) Plus Lutetium (177Lu) Vipivotide Tetraxetan in Patients With Metastatic Castration Resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct07047118/), [A Study of Niraparib Combination Therapies for the Treatment of Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct03431350/), [A Study of Opevesostat (MK-5684) Versus Alternative Next-generation Hormonal Agent (NHA) in Metastatic Castration-resistant Prostate Cancer (mCRPC) Post One NHA (MK-5684-004)](https://onco.cc/trials/nct06136650/), [A Study of Pasritamig With Docetaxel Versus Docetaxel in Participants With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct07225946/), [A Study of Pasritamig With or Without JNJ-87189401 Versus Placebo for Late Line Metastatic Castration-resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/mcrpc/), [A Study of SYNC-T Therapy SV-102 in Participants With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct06533644/), [A Study of TRC003 in the Treatment of Patients With Progressive PSMA-positive mCRPC](https://onco.cc/trials/nct07567521/), [A Study of Xaluritamig Plus Abiraterone Versus Investigator's Choice in Participants With Chemotherapy-naïve Metastatic Castration-resistant Prostate ](https://onco.cc/trials/nct07213674/), [A Study of XmAb20717 (Vudalimab)in Patients With Selected Advanced Gynecologic and Genitourinary Malignancies](https://onco.cc/trials/nct05032040/), [A Study to Assess the Safety, Pharmacokinetics, and Anti-Tumor Activity of Oral HP518 in mCRPC Patients](https://onco.cc/trials/nct06155084/), [A Study to Compare the Efficacy and Safety of BMS-986365 Versus the Investigator's Choice of Therapy in Participants With Metastatic Castration-resistant Prostate Cancer](https://onco.cc/trials/nct06764485/), [A Study to Evaluate the Safety, Pharmacokinetics, Pharmacodynamics, and Antitumor Activity of INV-9956 in Adult Patients With Advanced Metastatic Castration Resistant Prostate Cancer](https://onco.cc/trials/nct06609005/), [A Study to Learn About the Investigational Drug Rinzimetostat (ORIC-944) in Patients With mCRPC Who Were Previously Treated With Abiraterone Acetate (Himalayas-1)](https://onco.cc/trials/himalayas-1/), [A Study to Learn How PF-06821497 (Mevrometostat) Works in Men With Metastatic Castration-resistant Prostate Cancer.](https://onco.cc/trials/nct06629779/), [A Study to Test Inavolisib Treatment in Participants With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct07287150/), [A Trial Evaluating the Efficacy and Safety of HC-1119 Soft Capsules in Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC).](https://onco.cc/trials/nct03851640/), [A Trial to Find Out if REGN4336 is Safe and How Well it Works Alone and in Combination With REGN5678 for Adult Participants With Advanced Prostate Cancer](https://onco.cc/trials/nct05125016/), [A Trial to Find Out if REGN5678 (Nezastomig) is Safe and How Well it Works Alone or in Combination With Cemiplimab for Adult Participants With Metasta](https://onco.cc/trials/nct03972657/), [AFFINITY](https://onco.cc/trials/affinity-custirsen/), [AFFIRM](https://onco.cc/trials/affirm/), [AlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)](https://onco.cc/trials/alphabreak/), [ALSYMPCA](https://onco.cc/trials/alsympca/), [An Efficacy and Safety Study of Apalutamide (JNJ-56021927) in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone in Participants With Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct02257736/), [An Open-label Dose Escalation and Expansion, Followed by a Phase II Study of Tulmimetostat (DZR123) and JSB462 (Luxdegalutamide) in Patients With Progressive Metastatic Castrate Resistant Prostate Cancer (mCRPC) (TulmiSTAR-01)](https://onco.cc/trials/nct07206056/), [An Open-label Study of Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI Versus AAA617 in PSMA Positive First-line mCRPC](https://onco.cc/trials/nct06894511/), [Anti-tumour Activity of (177Lu) rhPSMA-10.1 Injection](https://onco.cc/trials/nct05413850/), [ARMOR3-SV](https://onco.cc/trials/armor3-sv/), [AZD2265 Compared With Standard of Care in PSMA-positive Metastatic Castration-resistant Prostate Cancer (VECTRA-01)](https://onco.cc/trials/nct07611110/), [CA184-043](https://onco.cc/trials/ca184-043-ipilimumab/), [CALGB 90401](https://onco.cc/trials/calgb-90401/), [CARD](https://onco.cc/trials/card/), [COMET-1](https://onco.cc/trials/comet-1/), [COU-AA-301](https://onco.cc/trials/cou-aa-301/), [COU-AA-302](https://onco.cc/trials/cou-aa-302/), [ECLIPSE](https://onco.cc/trials/eclipse-psma/), [ELM-PC 4](https://onco.cc/trials/elm-pc-4-orteronel/), [ENTHUSE M1](https://onco.cc/trials/enthuse-m1-zibotentan/), [ERA 223](https://onco.cc/trials/era-223/), [First-Time-in-Human Study of GSK5471713 in Adults With mCRPC](https://onco.cc/trials/nct07332455/), [FIRSTANA](https://onco.cc/trials/firstana/), [FPI-2265 (225Ac-PSMA-I&T) and Olaparib for Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct06909825/), [Gedatolisib in Combination With Darolutamide in Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct06190899/), [IMbassador250](https://onco.cc/trials/imbassador250/), [IMPACT (sipuleucel-T)](https://onco.cc/trials/impact-sipuleucel-t/), [KEYNOTE-641](https://onco.cc/trials/keynote-641/), [KEYNOTE-921](https://onco.cc/trials/keynote-921/), [MAGNITUDE](https://onco.cc/trials/magnitude/), [Metastatic Castrate-Resistant Prostate Cancer Subjects Treated With PROVENGE® + One Infusion of Sipuleucel-T](https://onco.cc/trials/nct06134232/), [MEVPRO-1](https://onco.cc/trials/mevpro-1/), [ONC-392 Plus Lutetium Lu 177 Vipivotide Tetraxetan in Patients With mCRPC](https://onco.cc/trials/nct05682443/), [Open-label Study Comparing AAA817 Versus Standard of Care in the Treatment of Previously Treated PSMA-positive mCRPC Adults Who Have Disease Progressed on or After [177Lu]Lu-PSMA Targeted Therapy](https://onco.cc/trials/nct06780670/), [PEACE-3 (EORTC 1333)](https://onco.cc/trials/peace-3/), [PREVAIL](https://onco.cc/trials/prevail/), [PROfound](https://onco.cc/trials/profound/), [PROpel](https://onco.cc/trials/propel/), [PROSELICA](https://onco.cc/trials/proselica/), [PROSPECT](https://onco.cc/trials/prospect-prostvac/), [PSMAfore](https://onco.cc/trials/psmafore/), [READY](https://onco.cc/trials/ready-dasatinib/), [REGN15505 (PSMAx4-1BB) Alone or in Combination With Cemiplimab or REGN4336 (PSMAxCD3) in Adult Patients With Metastatic Castration-Resistant Prostate ](https://onco.cc/trials/nct07594106/), [Safety and Pharmacokinetics of ODM-208 in Patients With Metastatic Castration-resistant Prostate Cancer](https://onco.cc/trials/nct03436485/), [SPLASH](https://onco.cc/trials/splash/), [Study Comparing AAA817+ARPI Versus Standard of Care in Adult Participants With PSMA-positive mCRPC](https://onco.cc/trials/nct06855277/), [Study of Cabozantinib in Combination With Atezolizumab Versus Second NHT in Subjects With mCRPC](https://onco.cc/trials/nct04446117/), [Study of Capivasertib + Docetaxel vs Placebo + Docetaxel as Treatment for Metastatic Castration Resistant Prostate Cancer (mCRPC)](https://onco.cc/trials/nct05348577/), [Study of Lutetium (177Lu) Vipivotide Tetraxetan in mCRPC Participants With Moderately and Severely Impaired and With Normal Renal Function](https://onco.cc/trials/nct06004661/), [Study of Opevesostat (MK-5684) Versus Alternative NHA in mCRPC (MK-5684-003)](https://onco.cc/trials/nct06136624/), [Study of Pembrolizumab (MK-3475) Combination Therapies in Metastatic Castration-Resistant Prostate Cancer (MK-3475-365/KEYNOTE-365)](https://onco.cc/trials/nct02861573/), [Study of SX-682 Plus Enzalutamide in Men With ARPI-Resistant Metastatic Castration Resistant Prostate Cancer](https://onco.cc/trials/nct06228053/), [Study of XNW5004 Tablet in Combination With Enzalutamide in Subjects With Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct06702995/), [Study on Olaparib Plus Abiraterone as First-line Therapy in Men With Metastatic Castration-resistant Prostate Cancer (China Cohort)](https://onco.cc/trials/nct05171816/), [Substudy 01A: Safety and Efficacy of Opevesostat (MK-5684)-Based Treatment Combinations or Opevesostat Alone in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) (MK-5684-01A)](https://onco.cc/trials/nct06353386/), [SWOG 9916](https://onco.cc/trials/swog-9916/), [SWOG S0421](https://onco.cc/trials/swog-s0421-atrasentan/), [SYNERGY](https://onco.cc/trials/synergy-custirsen/), [TALAPRO-2](https://onco.cc/trials/talapro-2/), [Targeted Alpha Therapy With 225Actinium-Prostate Specific Membrane Antigen (PSMA)-I&T of Castration-resISTant Prostate Cancer (TATCIST).](https://onco.cc/trials/nct05219500/), [TAX 327](https://onco.cc/trials/tax-327/), [The Study of 177Lu-TLX591 Plus SOC Versus SOC Alone in Patients With mCRPC (ProstACT Global)](https://onco.cc/trials/nct06520345/), [TheraP (ANZUP 1603)](https://onco.cc/trials/therap/), [TRITON3](https://onco.cc/trials/triton3/), [TROPIC](https://onco.cc/trials/tropic/), [VISION](https://onco.cc/trials/vision/), [XALute](https://onco.cc/trials/xalute/), [ZEN003694 and Enzalutamide Versus Enzalutamide Monotherapy in Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct04986423/)
- technologies: [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/)
- roadmaps: [Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch](https://onco.cc/roadmaps/prostate-roadmap/)
- ideas: [Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer](https://onco.cc/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/), [Take high-dose testosterone to phase 3, with progression-free survival through the second line as the primary endpoint](https://onco.cc/ideas/idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2/), [Test every man for DNA repair faults on the day his prostate cancer is found to have spread, not three treatments later](https://onco.cc/ideas/idea-prostate-hrr-testing-at-metastatic-diagnosis/), [Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on it](https://onco.cc/ideas/idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine/)
- institutions: [Prostate Cancer UK](https://onco.cc/institutions/prostate-cancer-uk/), [The Royal Marsden](https://onco.cc/institutions/royal-marsden/)
- biomarkers: [AR amplification (gene and upstream enhancer)](https://onco.cc/biomarkers/ar-amplification/), [AR ligand-binding-domain mutation (L702H, W742C, H875Y, T878A, F877L)](https://onco.cc/biomarkers/ar-ligand-binding-domain-mutation/), [AR-V7 splice variant](https://onco.cc/biomarkers/ar-v7-splice-variant/), [B7-H3 (CD276) expression](https://onco.cc/biomarkers/b7-h3-expression/), [Circulating tumour DNA fraction (and what a negative plasma result means)](https://onco.cc/biomarkers/ctdna-tumour-fraction/), [Germline BRCA1/2 pathogenic variant (gBRCAm)](https://onco.cc/biomarkers/brca-germline/), [Homologous recombination repair gene mutation in prostate cancer](https://onco.cc/biomarkers/hrr-gene-mutation/), [MSI-high (microsatellite instability by PCR or sequencing)](https://onco.cc/biomarkers/msi-high/), [PSMA expression by PET (PSMA-positive)](https://onco.cc/biomarkers/psma-pet-expression/), [PTEN alteration (sequencing) and PTEN loss (IHC)](https://onco.cc/biomarkers/pten-alteration/), [Treatment-emergent neuroendocrine transformation (recognising it)](https://onco.cc/biomarkers/nepc-transformation/), [Tumour (somatic or germline) BRCA1/2 mutation and HRR gene alterations](https://onco.cc/biomarkers/brca-somatic/)
- targets: [CYP17A1 (17-alpha-hydroxylase/17,20-lyase)](https://onco.cc/targets/cyp17a1/), [EZH2](https://onco.cc/targets/ezh2/), [KLK3](https://onco.cc/targets/klk3/), [PARP](https://onco.cc/targets/parp/), [PSMA](https://onco.cc/targets/psma/), [SOX2](https://onco.cc/targets/sox2/)
- people: [Chris C. Parker](https://onco.cc/people/chris-parker/), [Fred Saad](https://onco.cc/people/fred-saad/)
- pathways: [Clonal haematopoiesis (CHIP)](https://onco.cc/pathways/clonal-haematopoiesis/)

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JSON: https://onco.cc/api/v1/entities/prostate-mcrpc.json