Hamid Agus Rizal A H, Luna-Velez Maria V, Dudek Aleksandra M, Jansen Cornelius F J, Smit Frank, Aalders Tilly W, Verhaegh Gerald W, Schaafsma Ewout, Sedelaar John P M, Schalken Jack A
Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands.
Department of Urology, Ciptomangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Front Oncol. 2021 Aug 19;11:721659. doi: 10.3389/fonc.2021.721659. eCollection 2021.
Castration-resistant prostate cancer (CRPC) is defined by resistance of the tumor to androgen deprivation therapy (ADT). Several molecular changes, particularly in the AR signaling cascade, have been described that may explain ADT resistance. The variety of changes may also explain why the response to novel therapies varies between patients. Testing the specific molecular changes may be a major step towards personalized treatment of CRPC patients. The aim of our study was to evaluate the molecular changes in the AR signaling cascade in CRPC patients. We have developed and validated several methods which are easy to use, and require little tissue material, for exploring AR signaling pathway changes simultaneously. We found that the AR signaling pathway is still active in the majority of our CRPC patients, due to molecular changes in AR signaling components. There was heterogeneity in the molecular changes observed, but we could classify the patients into 4 major subgroups which are: AR mutation, AR amplification, active intratumoral steroidogenesis, and combination of AR amplification and active intratumoral steroidogenesis. We suggest characterizing the AR signaling pathway in CRPC patients before beginning any new treatment, and a recent fresh tissue sample from the prostate or a metastatic site should be obtained for the purpose of this characterization.
去势抵抗性前列腺癌(CRPC)的定义是肿瘤对雄激素剥夺疗法(ADT)产生抵抗。已经描述了几种分子变化,特别是在雄激素受体(AR)信号级联反应中,这些变化可能解释了ADT抵抗的原因。这些变化的多样性也可以解释为什么患者对新疗法的反应存在差异。检测特定的分子变化可能是迈向CRPC患者个性化治疗的重要一步。我们研究的目的是评估CRPC患者AR信号级联反应中的分子变化。我们已经开发并验证了几种易于使用且所需组织材料少的方法,用于同时探索AR信号通路的变化。我们发现,由于AR信号成分的分子变化,AR信号通路在大多数CRPC患者中仍然活跃。观察到的分子变化存在异质性,但我们可以将患者分为4个主要亚组,即:AR突变、AR扩增、肿瘤内活性类固醇生成以及AR扩增与肿瘤内活性类固醇生成的组合。我们建议在开始任何新治疗之前对CRPC患者的AR信号通路进行特征分析,为此应获取一份来自前列腺或转移部位的近期新鲜组织样本。