Adaptation and clonal selection models of castration-resistant prostate cancer: Current perspective

被引:41
作者
Ahmed, Muhammed [1 ,2 ,3 ]
Li, Long-Cheng [1 ,2 ]
机构
[1] Univ Calif San Francisco, Dept Urol, San Francisco, CA 94158 USA
[2] Univ Calif San Francisco, Helen Diller Family Comprehens Canc Ctr, San Francisco, CA 94158 USA
[3] Ahmadu Bello Univ, Dept Surg, Div Urol, Zaria, Nigeria
基金
美国国家卫生研究院;
关键词
adaptation; castration-resistance; clonal selection; prostate cancer; ANDROGEN-RECEPTOR GENE; TUMOR-SUPPRESSOR GENE; IN-SITU HYBRIDIZATION; STEM-CELL COMPOSITION; C-MYC ONCOGENE; INTRAEPITHELIAL NEOPLASIA; INDEPENDENT GROWTH; EXPRESSION; P53; PROGRESSION;
D O I
10.1111/iju.12005
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
100201 [内科学]; 100221 [泌尿外科学];
摘要
Prostate cancer is a leading cause of cancer deaths in men worldwide. Management of the disease has remained a great challenge and even more so is the aggressive advanced stage with castration-resistant behavior. The mechanisms and timing of development of castration-resistant prostate cancer are unclear and remain debatable. Progression to castration-resistant prostate cancer is undoubtedly multifactorial, with a number of molecular-genetic aberrations implicated. However, a key question that remains unanswered is: when in the evolution of prostate cancer do the changes that confer castration resistance occur? Earlier attempts to address this question led to two proposed models: the adaptation and the clonal selection models. Although the prevailing hypothesis is the adaptation model, there is recent evidence in favor of the clonal selection model. Clarification of the model development of castration-resistant prostate cancer might significantly alter our diagnostic and therapeutic strategies, and potentially lead to improved outcome of management of this daunting condition. Here we review existing knowledge and current research findings addressing the timing of events in the course of prostate cancer progression to castration-resistant prostate cancer.
引用
收藏
页码:362 / 371
页数:10
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