Taxanes – docetaxel and cabazitaxel – are the most active chemotherapy drugs currently used for the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, despite a good initial response and survival benefit, nearly all patients eventually develop resistance, which is an important barrier to long-term survival. Resistance to taxanes is also associated with cross-resistance to androgen receptor signaling inhibitors (ARSIs). Unfortunately, other than platinum-based treatments, which have demonstrated some benefit in a subset of patients with Aggressive Variant Prostate Cancer (AVPC), few therapeutic options are available to patients progressing to taxanes. Hence, more research is required to determine whether platinum-based chemotherapy will confer a survival benefit in mCRPC, and the identification of predictive biomarkers and the clinical evaluation of platinum compounds in molecularly selected patients is an urgent but unmet clinical need. The present review focuses on the current status of chemotherapy treatments in mCRPC, interactions with androgen deprivation therapy (ADT) and novel ARSIs, and the main mechanisms of resistance. We will examine the impact of platinum-based treatments in mCRPC and summarize the known predictive biomarkers of platinum response. Finally, future approaches and avenues will be discussed.

紫杉烷类——多西他赛和卡巴他赛——是目前用于治疗转移性去势抵抗性前列腺癌 (mCRPC) 的最活跃的化疗药物。然而，尽管有良好的初始反应和生存获益，但几乎所有患者最终都会产生耐药性，这是长期生存的重要障碍。对紫杉烷类的耐药性也与对雄激素受体信号抑制剂 (ARSI) 的交叉耐药性有关。不幸的是，除了基于铂的治疗（已在一部分侵袭性变异型前列腺癌 (AVPC) 患者中显示出一些益处）之外，很少有治疗选择可供进展为紫杉烷类的患者使用。因此，需要更多的研究来确定基于铂的化学疗法是否会给 mCRPC 带来生存益处，在分子选择的患者中，预测性生物标志物的鉴定和铂化合物的临床评估是一项紧迫但尚未满足的临床需求。本综述重点关注 mCRPC 化疗的现状、与雄激素剥夺疗法 (ADT) 和新型 ARSI 的相互作用，以及耐药的主要机制。我们将研究基于铂的治疗对 mCRPC 的影响，并总结已知的铂反应预测生物标志物。最后，将讨论未来的方法和途径。以及主要的耐药机制。我们将研究基于铂的治疗对 mCRPC 的影响，并总结已知的铂反应预测生物标志物。最后，将讨论未来的方法和途径。以及主要的耐药机制。我们将研究基于铂的治疗对 mCRPC 的影响，并总结已知的铂反应预测生物标志物。最后，将讨论未来的方法和途径。