前列腺癌
癌症研究
雄激素受体
背景(考古学)
表观遗传学
DNA甲基化
靶向治疗
医学
腺癌
前列腺
癌症
生物
内科学
基因
遗传学
古生物学
基因表达
出处
期刊:Advances in Anatomic Pathology
[Ovid Technologies (Wolters Kluwer)]
日期:2024-01-15
卷期号:31 (2): 70-79
被引量:1
标识
DOI:10.1097/pap.0000000000000431
摘要
Treatment-related neuroendocrine prostate cancer is a distinctive category of prostate cancer that arises after intensive suppression of the androgen receptor by next-generation therapeutic inhibition of androgen receptor signaling. The biological processes that set in motion the series of events resulting in transformation of adenocarcinoma to neuroendocrine carcinoma include genomic (loss of tumor suppressors TP53 and RB1, amplification of oncogenes N-MYC and Aurora Kinase A, dysregulation of transcription factors SOX2, achaete-scute-homolog 1, and others) as well as epigenomic (DNA methylation, EZH2 overexpression, and others). Pathologic diagnosis is key to effective therapy for this disease, and this is aided by localizing metastatic lesions for biopsy using radioligand imaging in the appropriate clinical context. As our understanding of biology evolves, there has been increased morphologic recognition and characterization of tumor phenotypes that are present in this advanced post-treatment setting. New and promising biomarkers (delta-like ligand 3 and others) have been discovered, which opens up novel therapeutic avenues including immunotherapy and antibody-drug conjugates for this lethal disease with currently limited treatment options.
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