Chawnshang Chang Sex Hormone Research Center, Tianjin Institute of Urology, Tianjin Medical University, Tianjin, 300211, China; George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, 14642, USA.
George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, 14642, USA; Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
Cancer Lett. 2018 Dec 28;439:47-55. doi: 10.1016/j.canlet.2018.09.020. Epub 2018 Sep 15.
Prostate cancer (PCa) is the most common cancer and the 2nd leading cause of cancer-related deaths among men in the United States. Androgen-deprivation-therapy (ADT) with antiandrogens to target the androgens/androgen receptor (AR) signals remains the standard therapy for advanced PCa. However, most of the PCa patients who received ADT with antiandrogens, including the recently developed Enzalutamide (Enz) that might extend PCa patients survival an extra 4.8 months, will still develop the castration (or antiandrogen) resistance. Mechanism dissection studies suggest these antiandrogen resistances may involve the induction of AR splicing variants and/or AR mutants. Further preclinical in vitro/in vivo studies suggest ADT-antiandrogens may also enhance the neuroendocrine differentiation (NED) and PCa cell invasion, and these unwanted side-effects may function through various mechanisms including altering the infiltrating inflammatory cells within the prostate tumor microenvironment. This review summarizes these unwanted ADT-induced side-effects and discusses multiple approaches to overcome these side-effects to better suppress the PCa at the castration resistant stage.
前列腺癌(PCa)是美国男性中最常见的癌症和癌症相关死亡的第二大原因。去势治疗(ADT)联合抗雄激素药物靶向雄激素/雄激素受体(AR)信号仍然是晚期 PCa 的标准治疗方法。然而,大多数接受 ADT 联合抗雄激素治疗的 PCa 患者,包括最近开发的恩杂鲁胺(Enz),可能会使 PCa 患者的生存时间延长 4.8 个月,仍会发生去势(或抗雄激素)耐药。机制研究表明,这些抗雄激素耐药性可能涉及 AR 剪接变体和/或 AR 突变体的诱导。进一步的临床前体外/体内研究表明,ADT-抗雄激素药物也可能增强神经内分泌分化(NED)和 PCa 细胞侵袭,这些不良的副作用可能通过多种机制发挥作用,包括改变前列腺肿瘤微环境中浸润的炎症细胞。本综述总结了这些不期望的 ADT 诱导的副作用,并讨论了多种克服这些副作用的方法,以更好地抑制去势抵抗阶段的 PCa。