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Castration-recurrent prostate cancer is not androgen-independent.
Abstract
An American man is diagnosed with prostate cancer (PC) every 3 min and dies from the disease every 17 min. Although androgen receptor (AR) expression is diminished following androgen deprivation therapy (ADT) that induces clinical remission in most patients, castration-recurrent PC expresses levels of AR protein similar to those found in androgen-stimulated PC and benign prostate. This observation suggests that the AR may be as important for growth regulation in castration-recurrent PC, as it is in androgen-stimulated PC and benign hyperplasia. Neither ligand-independence, point mutations, glutamine and/or glycine repeat expansion nor amplification have explained AR activation in most cases of castration-recurrent PC. Castration-recurrent PC tissue has levels of testosterone (T) similar to androgen-stimulated benign prostate and levels of dihydrotestosterone (DHT), the most active androgen for AR activation that are approximately 10% of androgen-stimulated benign prostate. These levels of tissue androgens appear capable of activating the AR since prostate-specific antigen (PSA), the classic androgen-regulated gene, is expressed at similar tissue levels in castration-recurrent and androgen-stimulated PC. These startling findings suggest a paradigm shift; PC that recurs during ADT is not androgen-independent.
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“However, a paradigm shift occurred upon reports by a number of groups demonstrating that despite being surgically or chemically castrated, very low levels of androgens are still detectable in the tissues and serum of advanced patients (2,3).”
From Minireview: Alternative Activation Pathways for the Androgen Receptor in Prostate Cancer (2011) · cites this paper as [3]
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Metadata
- Authors
- Mohler, J. L.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Mohler, James L.
- ORCID
- Mohler, James L.
- Venue
- Advances in experimental medicine and biology
- Publisher
- Springer New York
- Published
- 2008
- Volume
- 617
- Pages
- 223-234
- ISSN
- 0065-2598 (ISSN-L)
- OpenAlex
- W202356157
- Cited by
- 106
- References
- 57
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 9 · 2015: 9 · 2014: 9 · 2013: 15 · 2012: 8
- FWCI
- 62.53
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Advances in experimental medicine and biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Prostate Cancer Treatment and Research
- Health Sciences › Medicine › Urology › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- castration-resistant prostate cancer, recurrent prostate cancer, androgen receptor, androgen-independent growth, androgen deprivation therapy, dihydrotestosterone, testosterone, prostate-specific antigen, androgen receptor activation, benign prostatic hyperplasia
- MeSH terms
- Androgens, Humans, Male, Neoplasm Recurrence, Local, Neoplasms, Hormone-Dependent, Orchiectomy, Prostatic Neoplasms, Receptors, Androgen
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