Targeting the Androgen Signaling Axis in Prostate Cancer

J Clin Oncol. 2023 Sep 10;41(26):4267-4278. doi: 10.1200/JCO.23.00433. Epub 2023 Jul 10.

Abstract

Activation of the androgen receptor (AR) and AR-driven transcriptional programs is central to the pathophysiology of prostate cancer. Despite successful translational efforts in targeting AR, therapeutic resistance often occurs as a result of molecular alterations in the androgen signaling axis. The efficacy of next-generation AR-directed therapies for castration-resistant prostate cancer has provided crucial clinical validation for the continued dependence on AR signaling and introduced a range of new treatment options for men with both castration-resistant and castration-sensitive disease. Despite this, however, metastatic prostate cancer largely remains an incurable disease, highlighting the need to better understand the diverse mechanisms by which tumors thwart AR-directed therapies, which may inform new therapeutic avenues. In this review, we revisit concepts in AR signaling and current understandings of AR signaling-dependent resistance mechanisms as well as the next frontier of AR targeting in prostate cancer.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Androgens* / therapeutic use
  • Humans
  • Male
  • Prostatic Neoplasms, Castration-Resistant* / drug therapy
  • Prostatic Neoplasms, Castration-Resistant* / genetics
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Receptors, Androgen / genetics
  • Signal Transduction

Substances

  • Androgens
  • Receptors, Androgen