Abstract

he androgen receptor, upon binding to a ligand, functions as a transcription factor, ultimately helping to maintain the proper structure and function of the prostate. In prostate cancer, the constant activation of the androgen pathway in the cell leads to the proliferation of cancer cells and the development of prostate cancer. The individual stages of androgen signaling have become the target of anti-androgen therapy, which ultimately results in a decrease in testosterone levels in the cell. Over time, the duration of therapy leads to the emergence of new mechanisms of resistance in prostate cancer cells, such as an increase in the number of androgen receptors or endogenous synthesis of testosterone. This ultimately leads to the evolution of cancer cells into castration-resistantprostate cancer. This article aims to review and compare contemporary anti-hormonal drugs used in prostate cancer. New generation drugs such as enzalutamide, apalutamide, and darolutamide bind to the androgen receptor and inhibit its translocation to the cell nucleus. Abiraterone acetate inhibits endogenous testosterone synthesis, while relugolix is the first oral gonadotropin-releasing hormone analogue that does not cause a “flare” effect. Understanding the molecular mechanisms and biology of the androgen receptor is crucial for future directions in the development of prostate cancer drug therapies and their appropriate use.

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