Can targeting the androgen receptor in localized prostate cancer provide insights into why men with metastatic castration-resistant prostate cancer die?

摘要

The improved survival observed with abiraterone acetate1'2 or enzalutamide3'4 in patients with metastatic castration-resistant prostate cancer (mCRPC) who experience disease progression despite conventional androgen-deprivation therapy (ADT) validates the an-drogen receptor (AR) as a viable target in this group of patients. Yet many questions remain, particularly in light of the so-called bookends of the published clinical data that lead to the approval of these drugs. On one end of the spectrum, the fairly remarkable success that has been observed with these agents has been paired with the equally sobering realization that the development of resistance to these agents is nearly universal and is often associated with the'Mevelopment of a highly aggressive phenotype with rapidly progressive, fatal disease, for which few viable therapeutic options exist.