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Androgen receptor gene mutation, rearrangement, polymorphism
Kurtis Eisermann1, Dan Wang1, Yifeng Jing1
1Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, 15232, USA.
Abstract:
Genetic aberrations of the androgen receptor (AR) caused by mutations, rearrangements, and polymorphisms result in a mutant receptor that has varied functions compared to wild type AR. To date, over 1,000 mutations have been reported in the AR with most of these being associated with androgen insensitivity syndrome (AIS). While mutations of AR associated with prostate cancer occur less often in early stage localized disease, mutations in castration-resistant prostate cancer (CRPC) patients treated with anti-androgens occur more frequently with 10-30% of these patients having some form of mutation in the AR. Resistance to anti-androgen therapy usually results from gain-of-function mutations in the LBD such as is seen with bicalutamide and more recently with enzalutamide (MDV3100). Thus, it is crucial to investigate these new AR mutations arising from drug resistance to anti-androgens and other small molecule pharmacological agents.
Insights
Genetic aberrations in the androgen receptor (AR) drive prostate cancer progression and anti-androgen resistance. Investigating new AR mutations is crucial for developing effective treatments for castration-resistant prostate cancer (CRPC).
Area of Science:
- Molecular Biology
- Genetics
- Oncology
Background:
- Androgen receptor (AR) genetic aberrations, including mutations and rearrangements, lead to altered receptor function compared to wild-type AR.
- Over 1,000 AR mutations are documented, primarily linked to androgen insensitivity syndrome (AIS).
- AR mutations are less common in early-stage prostate cancer but increase in castration-resistant prostate cancer (CRPC) patients (10-30%) undergoing anti-androgen therapy.
Purpose of the Study:
- To investigate novel androgen receptor (AR) mutations emerging in response to anti-androgen therapies.
- To understand the role of AR mutations in the development of resistance to small molecule pharmacological agents in CRPC.
Main Methods:
- Literature review of reported AR mutations in prostate cancer and AIS.
- Analysis of mutation data in the context of anti-androgen treatment resistance.
- Focus on gain-of-function mutations within the ligand-binding domain (LBD) of the AR.
Main Results:
- Gain-of-function mutations in the AR's LBD are a key mechanism for resistance to anti-androgens like bicalutamide and enzalutamide.
- Specific AR mutations confer resistance by altering receptor activity and signaling pathways.
Conclusions:
- Understanding AR mutation mechanisms is essential for overcoming therapeutic resistance in CRPC.
- Further research into AR mutations driven by drug resistance is critical for advancing prostate cancer treatment strategies.
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