Challenges in overcoming hormonal resistance in prostate cancer

The treatment landscape for prostate cancer has changed remarkably in the last few years, with several US FDA-approved drugs and a promising pipeline of new agents. The current paradigm of treatment for advanced prostate tumors, which are androgen dependent, is hormone ablation therapy. This can be achieved chemically through LHRH agonists or antagonists, or surgically through orchiectomy. Most tumors respond favorably to this treatment, but eventually the tumor develops a more aggressive castration resistant phenotype. This review will help the reader gain a better understanding of the current paradigm for treatment, efforts to overcome resistance, and the strategies for future development of targeted agents.