Redefining Hormone Resistance in Prostate Cancer
December 2009
in “
Therapeutic Advances in Medical Oncology
”
TLDR The conclusion suggests that prostate cancer should be classified by castration status and that new therapies targeting androgen receptor signaling show promise.
The document from 2009 redefines hormone resistance in prostate cancer by emphasizing the complexity of androgen receptor (AR) signaling in castration-resistant prostate cancer (CRPC). It critiques the outdated terms "hormone-sensitive" and "hormone-refractory," proposing a classification based on castration status. The paper highlights the potential of new therapies targeting AR signaling, including abiraterone acetate, which showed significant antitumor activity in phase I and II studies, and MDV3100, a second-generation AR antagonist with promising results in a phase I/II trial with 140 patients. It also discusses the TMPRSS2-ERG gene fusion, found in over 50% of prostate tumors, which is associated with a more aggressive phenotype and poor prognosis. The document introduces the term "androgen depleted" to describe tumors that progress despite castration and suggests that combination therapies targeting both ligand-dependent and ligand-independent AR pathways may be more effective.
