TY - JOUR
T1 - The role of ketoconazole in current prostate cancer care
AU - Patel, Vaibhav
AU - Liaw, Bobby
AU - Oh, William
N1 - Publisher Copyright:
© 2018, Springer Nature Limited.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Ketoconazole is a nonselective steroid 17α-hydroxylase/17,20 lyase (CYP17A1) inhibitor that has been used, off-label, as a second-line therapy for castration-resistant prostate cancer (CRPC). The drug has shown clinical efficacy without survival benefit. Despite not improving survival, ketoconazole has beneficial characteristics, such as its low cost, a relatively favourable toxicity profile compared with chemotherapy, and its efficacy both before and after chemotherapy. The approval of several new, highly effective treatments, including abiraterone acetate, enzalutamide, and apalutamide, warrants re-evaluation of the role of ketoconazole and other classic agents in achieving the optimal timing and sequencing of available agents to prolong survival and maintain patients’ quality of life. In the current CRPC treatment landscape, we believe that ketoconazole can be considered in patients with nonmetastatic CRPC and in those with metastatic CRPC who do not respond to, tolerate, or have access to chemotherapy and other standard therapeutic options.
AB - Ketoconazole is a nonselective steroid 17α-hydroxylase/17,20 lyase (CYP17A1) inhibitor that has been used, off-label, as a second-line therapy for castration-resistant prostate cancer (CRPC). The drug has shown clinical efficacy without survival benefit. Despite not improving survival, ketoconazole has beneficial characteristics, such as its low cost, a relatively favourable toxicity profile compared with chemotherapy, and its efficacy both before and after chemotherapy. The approval of several new, highly effective treatments, including abiraterone acetate, enzalutamide, and apalutamide, warrants re-evaluation of the role of ketoconazole and other classic agents in achieving the optimal timing and sequencing of available agents to prolong survival and maintain patients’ quality of life. In the current CRPC treatment landscape, we believe that ketoconazole can be considered in patients with nonmetastatic CRPC and in those with metastatic CRPC who do not respond to, tolerate, or have access to chemotherapy and other standard therapeutic options.
UR - http://www.scopus.com/inward/record.url?scp=85053183765&partnerID=8YFLogxK
U2 - 10.1038/s41585-018-0077-y
DO - 10.1038/s41585-018-0077-y
M3 - Review article
C2 - 30154429
AN - SCOPUS:85053183765
SN - 1759-4812
VL - 15
SP - 643
EP - 651
JO - Nature Reviews Urology
JF - Nature Reviews Urology
IS - 10
ER -