Molecular pathways and targets in prostate cancer

// Emma Shtivelman 1 , Tomasz M. Beer 2 and Christopher P. Evans 3 1 Cancer Commons, Palo Alto, CA 2 Oregon Health & Science University, Knight Cancer Institute, Portland, OR 3 Department of Urology and Comprehensive Cancer Center, University of California, Davis, CA Correspondence: Emma Shtivelman , email: // Keywords : prostate cancer, molecular targets, CRPC, localized prostate cancer Received : August 04, 2014 Accepted : August 28, 2014 Published : August 29, 2014 Abstract Prostate cancer co-opts a unique set of cellular pathways in its initiation and progression. The heterogeneity of prostate cancers is evident at earlier stages, and has led to rigorous efforts to stratify the localized prostate cancers, so that progression to advanced stages could be predicted based upon salient features of the early disease. The deregulated androgen receptor signaling is undeniably most important in the progression of the majority of prostate tumors. It is perhaps because of the primacy of the androgen receptor governed transcriptional program in prostate epithelium cells that once this program is corrupted, the consequences of the ensuing changes in activity are pleotropic and could contribute to malignancy in multiple ways. Following localized surgical and radiation therapies, 20-40% of patients will relapse and progress, and will be treated with androgen deprivation therapies. The successful development of the new agents that inhibit androgen signaling has changed the progression free survival in hormone resistant disease, but this has not changed the almost ubiquitous development of truly resistant phenotypes in advanced prostate cancer. This review summarizes the current understanding of the molecular pathways involved in localized and metastatic prostate cancer, with an emphasis on the clinical implications of the new knowledge.