Emerging insights of drug resistance in metastatic castration-resistant prostate cancer
In recent years, castration resistant prostate cancer patients therapeutic landscape has dramatically changed. The use of taxane-based chemotherapy, new generation hormone therapy, an immunotherapeutic agent Sipuleucel-T, an alpha-emitter Radium-223, and recently PARP-inhibitors has provided a consistent benefit in terms of survival and quality of life.
In particular, androgen receptor (AR) remains a key player of prostate cancer progression also in this setting and more effective therapeutic agents are still directed against AR pathway. Unfortunately, not all patients respond to available treatments and almost all will develop a drug resistance. The resistance mechanisms involve not only AR dependent signaling pathways but also AR independent cells survival pathways. In this review we discuss the potential mechanisms of resistance to drugs employed in the treatment of metastatic castration resistant prostate carcinoma patients.
Understanding the mechanisms of resistance in castration-resistant prostate cancer by investigating all agents used in this setting.
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