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Redefining hormone resistance in prostate cancer
Christopher J Hoimes1, W Kevin Kelly
1Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA.
Therapeutic Advances in Medical Oncology
|June 15, 2010
Summary
Prostate cancer progression depends on androgen receptor (AR) signaling. New classifications based on castration status, rather than hormone sensitivity, better describe disease progression and guide treatment for advanced prostate cancer.
Area of Science:
- Oncology
- Urology
- Endocrinology
Background:
- Prostate cancer growth is driven by androgen receptor (AR) signaling.
- Androgen-deprivation therapy is a primary treatment for advanced prostate cancer.
- Current classifications (hormone-sensitive, hormone-refractory) do not fully capture disease relapse mechanisms.
Purpose of the Study:
- To propose a new clinical classification framework for prostate cancer.
- To improve the understanding of disease progression and treatment response.
- To provide a better framework for patient management and drug development.
Main Methods:
- Review of current understanding of AR signaling in prostate cancer.
- Analysis of limitations in existing clinical classifications.
- Incorporation of new therapeutic strategies and resistance mechanisms.
Main Results:
- The Prostate Cancer Clinical Trials Working Group 2 (PCWG2) recommends classifying disease based on castration status.
- Ligand-centered terminology more accurately describes patient disease states.
- New therapeutics and resistance mechanisms necessitate a redefined 'castrate' state.
Conclusions:
- A revised classification based on castration status offers a more accurate description of prostate cancer.
- This framework aids in patient management and the development of novel therapeutics.
- Redefining hormone resistance to include adrenal and tumoral androgen ablation refines clinical states.
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