Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Section of Pathological Anatomy, School of Medicine, United Hospitals, Polytechnic University of the Marche Region, 60126 Ancona, Italy.
Cells. 2020 Dec 10;9(12):2653. doi: 10.3390/cells9122653.
Around 80-90% of prostate cancer (PCa) cases are dependent on androgens at initial diagnosis; hence, androgen ablation therapy directed toward a reduction in serum androgens and the inhibition of androgen receptor (AR) is generally the first therapy adopted. However, the patient's response to androgen ablation therapy is variable, and 20-30% of PCa cases become castration resistant (CRPCa). Several mechanisms can guide treatment resistance to anti-AR molecules. In this regard, AR-dependent and -independent resistance mechanisms can be distinguished within the AR pathway. In this article, we investigate the multitude of AR signaling aspects, encompassing the biological structure of AR, current AR-targeted therapies, mechanisms driving resistance to AR, and AR crosstalk with other pathways, in an attempt to provide a comprehensive review for the PCa research community. We also summarize the new anti-AR drugs approved in non-metastatic castration-resistant PCa, in the castration-sensitive setting, and combination therapies with other drugs.
大约 80-90%的前列腺癌(PCa)病例在初始诊断时依赖于雄激素;因此,通常采用针对血清雄激素降低和雄激素受体(AR)抑制的雄激素剥夺疗法。然而,患者对雄激素剥夺疗法的反应是可变的,20-30%的 PCa 病例会发展为去势抵抗(CRPCa)。几种机制可以指导抗 AR 分子的耐药性。在这方面,可以在 AR 途径内区分 AR 依赖性和非依赖性耐药机制。在本文中,我们研究了 AR 信号转导的多个方面,包括 AR 的生物学结构、当前的 AR 靶向治疗、导致 AR 耐药的机制以及 AR 与其他途径的串扰,试图为 PCa 研究界提供全面的综述。我们还总结了新批准的用于非转移性去势抵抗性 PCa、去势敏感性设置以及与其他药物联合治疗的抗 AR 药物。