Androgen receptor signaling pathway in prostate cancer: from genetics to clinical applications

G Aurilio, A Cimadamore, R Mazzucchelli… - Cells, 2020 - mdpi.com
G Aurilio, A Cimadamore, R Mazzucchelli, A Lopez-Beltran, E Verri, M Scarpelli, F Massari…
Cells, 2020mdpi.com
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 …
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.
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