Abstract
Prostate cancer is a very common disease, which is, unfortunately, often the cause of many male deaths. This is underlined by the fact that the early stages of prostate cancer are often asymptomatic. Therefore, the disease is usually detected and diagnosed at late advanced or even metastasized stages, which are already difficult to treat. Hence, it is important to pursue research and development not only in terms of novel diagnostic methods but also of therapeutic ones, as well as to increase the effectiveness of the treatment by combinational medicinal approach. Therefore, in this review article, we focus on recent approaches and novel potential tools for the treatment of advanced prostate cancer; these include not only androgen deprivation therapy, antiandrogen therapy, photodynamic therapy, photothermal therapy, immunotherapy, multimodal therapy, but also poly(ADP-ribose) polymerase, Akt and cyclin-dependent kinase inhibitors.
Highlights
Worldwide, the second most frequently diagnosed type of cancer affecting men is prostate cancer
One of the current treatment approaches of advanced prostate cancer focuses on male sex hormones, androgens, which regulate the proliferation of both tumor and normal prostate cells, i.e., starts with androgen deprivation therapy followed by antiandrogen therapy
poly(ADP-ribose) polymerase inhibitors (PARPi) rucaparib has been approved by the Food and Drug Administration (FDA) for the treatment of patients with metastatic CRPC (mCRPC) and BRCA1/2 mutations who have progressed after previous treatment with second-generation anti-androgen receptor (AR) drugs or taxane-based chemotherapy
Summary
The second most frequently diagnosed type of cancer affecting men is prostate cancer. The nonsteroidal ones (e.g., bicalutamide, flutamide) exhibit only antagonistic activity by which they block the binding of the AR and thereby inhibit tumor growth They do not reduce the testosterone serum levels, unlike steroid molecules [1,6,7]. While apalutamide is structurally similar to enzalutamide and has a 7–10 times higher affinity for the AR in human cells derived from prostate carcinoma (LNCaP) [19], the structure of darolutamide is unique and varies from other AR antagonists It is composed of two pharmacologically active diastereoisomers [20]. The steroidal ones have both agonistic and antagonistic androgenic activity which blocks the production of luteinizing hormone and follicle-stimulating hormone, by which they reduce the testosterone serum levels. The group of steroidal compounds with antiandrogenic activity comprises an antagonist of the mineralocorticoid receptor spironolactone (Aldactone®; Figure 1), the progesterone receptor antagonists RU-486 (mifepristone, Mifeprex®; Figure 1), and an atypical progestin cyproterone acetate (CPA, Androcur®; Figure 1) [21]
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