Prostate cancer (PC) is the leading cause of cancer and the second leading cause 
of cancer-death among men in the Western world. About 10-20% of men with PC 
present with metastatic disease at diagnosis, while 20-30% of patients diagnosed 
with localized disease will eventually develop metastases. Although most respond 
to initial androgen-deprivation therapy (ADT), progression to 
castration-resistant PC (CRPC) is universal. In 2004 the docetaxel/prednisone 
regimen was approved for the management of patients with metastatic CRPC, 
becoming the standard first-line therapy. Recent advances have now led to an 
unprecedented number of new drug approvals within the past years, providing many 
new treatment options for patients with metastatic CRPC. Four new drugs have 
received U.S. Food and Drug Administration (FDA)-approval in 2010 and 2011: 
sipuleucel-T, an immunotherapeutic agent; cabazitaxel, a novel microtubule 
inhibitor; abiraterone acetate, a new androgen biosynthesis inhibitor; and 
denosumab, a bone-targeting agent. The data supporting the approval of each of 
these agents are described in this review, as are current approaches in the 
treatment of metastatic CRPC and ongoing clinical trials of novel treatments and 
strategies.