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Updated: May 10, 2026

Sequencing Small Non-coding RNA from Formalin-fixed Tissues and Serum-derived Exosomes from Castration-resistant Prostate Cancer Patients
Published on: November 19, 2019
Molecular biology of castration-resistant prostate cancer: basis for the novel therapeutic targets
Begoña Mellado1, Mercedes Marin Aguilera, Maria Veronica Pereira
1Medical Oncology Department, ICMHO, Laboratory of Traslational Oncology, IDIBAPS, Hospital Clinic, Barcelona, Spain. bmellado@clinic.ub.es
Abstract:
Prostate cancer cells express the androgen receptor (AR) and need the presence of androgens to survive. Androgen suppression is the gold standard first-line therapy for metastatic disease. Almost all prostate cancer patients initially respond to hormonal therapy, but most of them gradually develop castration-resistant progression. Recent evidence has shown that progression at the castration resistant prostate cancer (CRPC) stage is often mediated by AR signalling. Importantly, subsequent AR androgen inhibition, by abiraterone acetate or enzalutamide, has shown to improve patients' survival. Several mechanisms that enhance AR signalling in an androgen-depleted environment have been elucidated:(1) AR mutations that allow activation by low androgen levels or by other endogenous steroids, (2) AR amplification and/or overexpression,(3)increased local intracrine synthesis of androgens, (4) changes in AR cofactors and (5) cross-talk with cytokines and growth factors. Today, there are under development a number of novel agents targeting the AR signaling pathway. This article reviews the postulated mechanisms of AR-driven resistance to androgen suppression that have contributed to the development of new hormonal therapeutic strategies in prostate cancer.
Insights
Prostate cancer initially responds to androgen suppression therapy. However, castration-resistant prostate cancer (CRPC) develops due to androgen receptor (AR) signaling, leading to new therapeutic strategies targeting AR.
Area of Science:
- Oncology
- Molecular Biology
- Endocrinology
Background:
- Prostate cancer relies on androgen receptor (AR) signaling for survival.
- Androgen suppression therapy is a primary treatment for metastatic prostate cancer.
- Most patients develop resistance, progressing to castration-resistant prostate cancer (CRPC).
Purpose of the Study:
- To review mechanisms of AR-driven resistance to androgen suppression in prostate cancer.
- To explore how these resistance mechanisms inform new therapeutic strategies.
- To highlight advancements in targeting AR signaling in CRPC.
Main Methods:
- Literature review of studies on AR signaling in prostate cancer.
- Analysis of elucidated mechanisms of androgen deprivation resistance.
- Synthesis of information on novel agents targeting the AR pathway.
Main Results:
- CRPC progression is frequently mediated by enhanced AR signaling.
- Mechanisms include AR mutations, amplification, overexpression, intracrine androgen synthesis, cofactor changes, and cross-talk.
- New hormonal therapies targeting AR signaling improve patient survival.
Conclusions:
- Understanding AR signaling mechanisms is crucial for overcoming resistance in prostate cancer.
- Targeting AR pathway alterations is key to developing effective CRPC treatments.
- Novel therapeutic strategies are emerging to combat AR-driven resistance.
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