Development of a second-generation antiandrogen for treatment of advanced prostate cancer

Chris Tran1, Samedy Ouk, Nicola J Clegg

  • 1Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

Science (New York, N.Y.)
|April 11, 2009
PubMed

Insights

New antiandrogen compounds, RD162 and MDV3100, effectively treat advanced prostate cancer. They target castration-resistant prostate cancer by inhibiting androgen receptor activity, showing promising results in preclinical and early clinical studies.

Area of Science:

  • Oncology
  • Pharmacology
  • Molecular Biology

Background:

  • Metastatic prostate cancer treatment often fails due to resistance mechanisms.
  • Castration-resistant prostate cancer (CRPC) is driven by elevated androgen receptor (AR) expression.
  • Existing anti-androgen therapies become ineffective against CRPC.

Purpose of the Study:

  • To characterize novel nonsteroidal anti-androgens, RD162 and MDV3100.
  • To evaluate their efficacy in preclinical models of CRPC.
  • To assess their safety and preliminary efficacy in a Phase I/II clinical trial.

Main Methods:

  • Compounds RD162 and MDV3100 were optimized from a screen for nonsteroidal anti-androgens.
  • AR binding affinity, nuclear translocation, DNA binding, and coactivator recruitment were assessed.
  • In vivo efficacy was tested in mouse models of CRPC.
  • A Phase I/II clinical trial was conducted to evaluate MDV3100 in patients with advanced prostate cancer.

Main Results:

  • RD162 and MDV3100 demonstrated higher AR binding affinity than bicalutamide.
  • Both compounds inhibited AR nuclear translocation, DNA binding, and coactivator recruitment.
  • RD162 and MDV3100 induced tumor regression in CRPC mouse models.
  • In the clinical trial, 43% of patients treated with MDV3100 showed significant prostate-specific antigen (PSA) declines.

Conclusions:

  • RD162 and MDV3100 are potent nonsteroidal anti-androgens active against CRPC.
  • These compounds represent promising therapeutic candidates for advanced prostate cancer.
  • MDV3100 warrants further investigation in larger clinical trials for CRPC treatment.

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