Summary
Activation of the androgen receptor is critical for prostate cancer growth at all points in the illness. Currently therapies targeting the androgen receptor, including androgen depletion approaches and antiandrogens, do not completely inhibit androgen receptor activity. Prostate cancer cells develop resistance to castration by acquiring changes such as AR overexpression that result in reactivation of the receptor. Based on understanding of these resistance mechanisms and androgen synthesis pathways, novel antiandrogens and androgen depleting agents have been tested. Notably, MDV3100, a novel antiandrogen designed for activity in prostate cancer model systems with overexpressed AR and, abiraterone acetate, a 17-α-hydroxylase/17,20 lyase inhibitor that blocks steroid biosynthesis in the adrenal gland and in the tumor, have demonstrated significant activity in early phase trials and are being tested in the phase III setting.