Drug-targeting strategies for prostate cancer

Prostate cancer is the most frequently diagnosed cancer in North American men and accounts for 10% of cancer-related deaths in men. Despite advances in early detection and aggressive treatment of early disease, the overall mortality rate has not appear to have fallen, indicating that the current therapies are not beneficial for life expectancy and new strategies are required. Prostate cancer is a dynamic evolving process that develops in distinct steps, with each step liable to additional genetic hits that change the cancer cell phenotype and alter the patterns of gene expression. The molecular events in prostate cancer are beginning to be understood, including altered expression of tumor suppressor genes, pro- and anti-apoptotic genes, and oncogenes associated with the progression of the disease; and specific genes that are expressed predominantly or exclusively in prostate cells, prostate cancer cells, and prostate metastasis cells. These latter genes on the level of DNA, RNA and protein products are the targets of several new approaches to prostate cancer therapy and are the focus of this review.