Eighty Years of Targeting Androgen Receptor Activity in Prostate Cancer: The Fight Goes on
1
Biochemistry and Molecular Biomedicine, Institute of Biomedicine of the University of Barcelona (IBUB), Edifici Helix, Carrer Baldiri Reixac 15-21, 08028 Barcelona, Spain
2
Imperial Centre for Translational & Experimental Medicine (ICTEM), Imperial College London, London W12 0NN, UK
3
Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(3), 509; https://doi.org/10.3390/cancers13030509
Submission received: 21 December 2020
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Revised: 25 January 2021
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Accepted: 25 January 2021
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Published: 29 January 2021
(This article belongs to the Collection Prostate Cancer—from Molecular Mechanisms to Clinical Care)
Simple Summary
Prostate cancer is the second most common cancer in men world-wide, with nearly 1.3 million new cases each year, and over the next twenty years the incidence and death rate are predicted to nearly double. For decades, this lethal disease has been more or less successfully treated using hormonal therapy, which has the ultimate aim of inhibiting androgen signalling. However, prostate tumours can evade such hormonal therapies in a number of different ways and therapy resistant disease, so-called castration-resistant prostate cancer (CRPC) is the major clinical problem. Somewhat counterintuitively, the androgen receptor remains a key therapy target in CRPC. Here, we explain why this is the case and summarise both new hormone therapy strategies and the recent advances in knowledge of androgen receptor structure and function that underpin them.
Abstract
Prostate cancer (PCa) is the most common cancer in men in the West, other than skin cancer, accounting for over a quarter of cancer diagnoses in US men. In a seminal paper from 1941, Huggins and Hodges demonstrated that prostate tumours and metastatic disease were sensitive to the presence or absence of androgenic hormones. The first hormonal therapy for PCa was thus castration. In the subsequent eighty years, targeting the androgen signalling axis, where possible using drugs rather than surgery, has been a mainstay in the treatment of advanced and metastatic disease. Androgens signal via the androgen receptor, a ligand-activated transcription factor, which is the direct target of many such drugs. In this review we discuss the role of the androgen receptor in PCa and how the combination of structural information and functional screenings is continuing to be used for the discovery of new drug to switch off the receptor or modify its function in cancer cells.
