DRUG THERAPY FOR ANDROGEN-POSITIVE BREAST CANCER

Abstract

There are some types of breast cancer (BC) that depend on their molecular characteristics. However, lately researchers provide date regarding the presence of additional receptors of triple negative breast cancer (TNBC). One of them is LA R-subtype that has androgen receptors (AR) on breast cancer cells. The role of AR in the development of this pathology is still controversial. According to some authors, stimulation of AR leads to the proliferation suppression, in the opinion of others – to the activation and potentiation of tumor invasion. There is also a version of the dichotomous effect of androgens that depends on the concentration of this hormone. The various effects of LA R-subtype therapy of BC are also explained by the presence of many other regulator proteins that interact with AR. The first attempts to treat BC with androgen have begun since the 40s of the last century, but in those years it did not have the desired effect and was not used until recently. Currently, the basic mechanisms of the effect of androgens on BC cells on the molecular level are known, and researches try to use androgen therapy, also in combination with aromatase inhibitors to increase the concentration of endogenous testosterone. The effects of selective androgen receptor modulators and anabolic steroids are being studied. However, in the last decade, the largest number of studies focused on the study of anti-androgen therapy. Patients receive AR antagonists, such as enzalutamide, bicalutamide, that are prescribed for prostate cancer. Enzalutamide blocks both androgen- and estrogen-mediated tumor growth, and therefore can be used regardless of the presence of estrogen receptors (ER), in contrast to bicalutamide. The results showed a significant increase in disease free survival up to 16.5 months in patients with hormone positive BC.