title: [Mechanisms of resistance to CYP17A1 inhibitors in castrate resistant prostate cancer].
abstract: BACKGROUND
  Abiraterone acetate has increased the overall survival of patients with metastatic castration-resistant prostate cancer. However, despite an initial response to treatment, many patients develop resistance to the drug. In this paper we present different hypotheses that may explain the emergence of resistance.
  
  
  METHODS
  This review was conducted from the PubMed database. The most relevant articles were selected and analyzed.
  
  
  RESULTS
  The molecular mechanisms of resistance to abiraterone acetate remain largely elusive. We detailed some of them including the reactivation of the androgen receptor through alternative biosynthesis of androgens, over expression or mutation of the androgen receptor gene, or the action of co-activators. The over expression of CYP17A1 or the alteration of other genes' expression involved in steroidogenesis could also contribute to the resistance.
  
  
  CONCLUSIONS
  Some of the molecular mechanisms involved in the resistance to abiraterone acetate were detailed. Better understanding of these mechanisms is a key step to allow the emergence of new therapeutic options and personalized treatments of castration resistant prostate cancer.
authors: Polyclinique de Courlancy, 38 bis rue de Courlancy, 51100 Reims, France. Electronic address: thomas_ripert@yahoo.fr.
authors: T
authors: T
authors: Ripert
authors: S
authors: S
authors: Crouzet
authors: G
authors: G
authors: Ploussard
authors: A
authors: A
authors: De La Taille
authors: G
authors: G
authors: Robert
mesh_terms: D000069501:Abiraterone Acetate; D000726:Androgen Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D009154:Mutation; D017430:Prostate-Specific Antigen / Q000235:genetics; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy / Q000201:enzymology / Q000235:genetics*; D011944:Receptors, Androgen / Q000235:genetics*; D013254:Steroid 17-alpha-Hydroxylase / Q000037:antagonists & inhibitors*; D016019:Survival Analysis
chemical_list: D000726:Androgen Antagonists; D000730:Androstadienes; D011944:Receptors, Androgen; C501892:CYP17A1 protein, human; D013254:Steroid 17-alpha-Hydroxylase; D017430:Prostate-Specific Antigen; D000069501:Abiraterone Acetate
keywords: Abiraterone acetate; Acétate d’abiratérone; Cancer de la prostate; Cancer de prostate résistant à la castration; Castration resistant prostate cancer; Prostate cancer; Resistance to abiraterone acetate; Résistance à l’acétate d’abiratérone