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Published on: March 6, 2018
The Interactions between Insulin and Androgens in Progression to Castrate-Resistant Prostate Cancer
Jennifer H Gunter1, Amy A Lubik, Ian McKenzie
1Australian Prostate Cancer Research Centre-Queensland, Queensland University of Technology, Princess Alexandra Hospital, Level 1, Building 1, Ipswich Road, Brisbane, QLD 4102, Australia.
Abstract:
An association between the metabolic syndrome and reduced testosterone levels has been identified, and a specific inverse relationship between insulin and testosterone levels suggests that an important metabolic crosstalk exists between these two hormonal axes; however, the mechanisms by which insulin and androgens may be reciprocally regulated are not well described. Androgen-dependant gene pathways regulate the growth and maintenance of both normal and malignant prostate tissue, and androgen-deprivation therapy (ADT) in patients exploits this dependence when used to treat recurrent and metastatic prostate cancer resulting in tumour regression. A major systemic side effect of ADT includes induction of key features of the metabolic syndrome and the consistent feature of hyperinsulinaemia. Recent studies have specifically identified a correlation between elevated insulin and high-grade PCa and more rapid progression to castrate resistant disease. This paper examines the relationship between insulin and androgens in the context of prostate cancer progression. Prostate cancer patients present a promising cohort for the exploration of insulin stabilising agents as adjunct treatments for hormone deprivation or enhancers of chemosensitivity for treatment of advanced prostate cancer.
Insights
Metabolic syndrome is linked to lower testosterone. This study explores the relationship between insulin and androgens in prostate cancer, suggesting insulin-stabilizing agents may aid treatment.
Area of Science:
- Endocrinology
- Oncology
- Metabolic Research
Background:
- Metabolic syndrome is associated with reduced testosterone levels, indicating metabolic crosstalk between insulin and androgen hormonal axes.
- Androgen-deprivation therapy (ADT) for prostate cancer can induce metabolic syndrome features, including hyperinsulinemia.
- Elevated insulin levels correlate with high-grade prostate cancer (PCa) and faster progression to castrate-resistant disease.
Purpose of the Study:
- To examine the intricate relationship between insulin and androgens in the context of prostate cancer progression.
- To explore the potential of insulin-stabilizing agents as adjunct therapies for prostate cancer patients undergoing ADT or with advanced disease.
Main Methods:
- Review of existing literature and studies investigating the interplay between metabolic syndrome, insulin, androgens, and prostate cancer.
- Analysis of correlations between insulin levels, prostate cancer grade, and treatment resistance.
- Examination of the effects of ADT on metabolic parameters and their implications for prostate cancer.
Main Results:
- A significant inverse relationship exists between insulin and testosterone levels, highlighting metabolic crosstalk.
- ADT, a standard prostate cancer treatment, is associated with the development of metabolic syndrome and hyperinsulinemia.
- Elevated insulin levels are linked to more aggressive prostate cancer and accelerated progression to castrate resistance.
Conclusions:
- The reciprocal regulation between insulin and androgens is crucial in prostate cancer progression.
- Prostate cancer patients are a key cohort for investigating insulin-stabilizing agents as potential adjunct treatments.
- Insulin-modulating therapies may enhance the efficacy of hormone deprivation or chemosensitivity in advanced prostate cancer.
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