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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Curr+Opin+Endocrinol+Diabetes+Obes 2016 ; 23 (3): 264-70 Nephropedia Template TP
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Current advances in intratumoral androgen metabolism in castration-resistant prostate cancer #MMPMID27119752
Purpose of review: Androgen deprivation therapy is a cornerstone in the treatment of advanced prostate cancer and has extended the lives of countless patients. Unfortunately, many of these patients eventually succumb to metastatic castration-resistant prostate cancer (mCRPC). The efficacy of abiraterone acetate (Zytiga) and enzalutamide (Enza, Xtandi) in the mCRPC setting prove that these tumors remain androgen-driven. We review recent studies that have shown that intratumoral androgen biosynthesis plays a significant role in the ever-evolving mCRPC tumor and we discuss the therapeutic implications of these findings. Recent findings: A novel abiraterone metabolite, D4A, possesses robust anti-tumor activity in rodent models via the inhibition of androgen biosynthetic enzymes and antagonism of AR. The TMPRSS2:ERG fusion drives AKR1C3 expression and activity to facilitate androgen biosynthesis and activate the androgen receptor (AR) in prostate cancer. Intracrine androgen formation and AKR1C3 expression and activity have been found to confer resistance to enzalutamide. Summary: These studies highlight the significant role that intratumoral androgen biosynthesis plays in the mCRPC tumor. The therapeutic implications include the inhibition of AKR1C3 in tumors that become resistant to current drugs such as AA or Enza and the potential administration of D4A as a mCRPC therapeutic.