In this study, we have developed and validated antibodies for immunohistochemistry (IHC) assays suitable for evaluation of full length AR (AR-FL) and AR-V7 in primary SCPC specimens. However, detailed expression pattern of different AR isoforms in primary SCPC patients who received prior ADT remains poorly characterized. Resistance to ADT in prostate cancer is often associated with aberrant androgen receptor (AR) activities mediated by AR protein overexpression, AR gene amplification, mutation and emergence of constitutively active AR variants such as AR splice variant-7 (AR-V7). The widespread application of potent next-generation hormonal therapies such as enzalutamide and abiraterone may also lead to increased occurrences of treatment related SCPC. SCPC frequently lacks expression of androgen receptor (AR) and AR downstream target genes such as prostate-specific antigen (PSA), and often responds poorly to androgen deprivation therapy (ADT). SCPC only accounts for 0.5%–2% of untreated primary prostate cancer at initial diagnosis, , but can present in up to 25% metastatic castration-resistant prostate cancer (CRPC) autopsies. Small cell prostate carcinoma (SCPC) is a rare and highly malignant subtype of prostate cancer.
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