DEVELOPMENT AND CLINICAL EFFECTIVENESS OF ANTIANDROGENS IN THE TREATMENT OF ADVANCED PROSTATE CANCER

Prostate cancer (PCa) is a hormonsensitive tumor. Due to the discovery of the androgen receptor (AR) it became possible to implement the antiandrogens as drugs blocking testosterone Binding to the AR into routine clinical practice. There have been discovered several generations of the antiandrogens over the years and the possibility of using these drugs in clinical practice has significantly changed. First generations of the antiandrogens (cyproterone, flutamid, bicalutamid) are used mainly for the treatment of advanced hormonsensitive PCa in combination with castration therapy. However these drugs do not increase survival in patients with PCa and are not indicated in terms of castration resistant PCa. Discovery of the enzalutamide (antiandrogen of 2’d generation), acting on the nuclear level of the tumor cell, allowed to increase significantly survival in patients with metastatic castration-resistant prostate cancer (mCRPC) and improve treatment results in patients with mCRPC. At the moment enzalutamide is being studied in combination with castration therapy in patients with hormonsensitive PCa.