Jun Luo1, Gerhardt Attard2, Steven P Balk3, Charlotte Bevan4, Kerry Burnstein5, Laura Cato6, Artem Cherkasov7, Johann S De Bono8, Yan Dong9, Allen C Gao10, Martin Gleave7, Hannelore Heemers11, Mayuko Kanayama12, Ralf Kittler13, Joshua M Lang14, Richard J Lee15, Christopher J Logothetis16, Robert Matusik17, Stephen Plymate18, Charles L Sawyers19, Luke A Selth20, Howard Soule21, Wayne Tilley20, Nancy L Weigel22, Amina Zoubeidi7, Scott M Dehm23, Ganesh V Raj24. 1. Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA. Electronic address: jluo1@jhmi.edu. 2. The Institute of Cancer Research, London, UK. 3. Hematology-Oncology Division, Beth Israel Deaconess Medical Center, Boston, MA, USA. 4. Department of Surgery & Cancer, Imperial College London, Imperial Centre for Translational & Experimental Medicine (ICTEM), Hammersmith Hospital Campus, London, UK. 5. Department of Molecular & Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA. 6. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 7. Department of Urologic Sciences, University of British Columbia, The Vancouver Prostate Centre, Vancouver, BC, Canada. 8. Division of Clinical Studies, The Institute of Cancer Research, London, UK. 9. Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA. 10. Department of Urology, University of California Davis, Sacramento, CA, USA. 11. Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Hematology/Medical Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. 12. Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan. 13. McDermott Center for Human Growth and Development, UT Southwestern Medical Center, Dallas, TX, USA. 14. Department of Medicine, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA. 15. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 16. Division of Cancer Medicine, Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 17. Department of Urologic Surgery, Vanderbilt Prostate Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA. 18. Department of Medicine, University of Washington and VAPSHCS GRECC, Seattle, WA, USA. 19. Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 20. Dame Roma Mitchell Cancer Research Laboratories and Freemasons Foundation Centre for Men's Health, Adelaide Medical School, The University of Adelaide, SA, Australia. 21. Prostate Cancer Foundation, Santa Monica, CA, USA. 22. Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA. 23. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA; Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA; Department of Urology, University of Minnesota, Minneapolis, MN, USA. Electronic address: dehm@umn.edu. 24. Department of Urology, UT Southwestern Medical Center at Dallas, Dallas, TX, USA; Department of Urology and Pharmacology, UT Southwestern Medical Center at Dallas, Dallas, TX, USA. Electronic address: ganesh.raj@utsouthwestern.edu.
Abstract
CONTEXT: Although a number of studies have demonstrated the importance of constitutively active androgen receptor variants (AR-Vs) in prostate cancer, questions still remain about the precise role of AR-Vs in the progression of castration-resistant prostate cancer (CRPC). OBJECTIVE: Key stakeholders and opinion leaders in prostate cancer convened on May 11, 2017 in Boston to establish the current state of the field of AR-Vs. EVIDENCE ACQUISITION: The meeting "Mission Androgen Receptor Variants" was the second of its kind sponsored by the Prostate Cancer Foundation (PCF). This invitation-only event was attended by international leaders in the field and representatives from sponsoring organizations (PCF and industry sponsors). Eighteen faculty members gave short presentations, which were followed by in-depth discussions. Discussions focused on three thematic topics: (1) potential of AR-Vs as biomarkers of therapeutic resistance; (2) role of AR-Vs as functionally active CRPC progression drivers; and (3) utility of AR-Vs as therapeutic targets in CRPC. EVIDENCE SYNTHESIS: The three meeting organizers synthesized this meeting report, which is intended to summarize major data discussed at the meeting and identify key questions as well as strategies for addressing these questions. There was a critical consensus that further study of the AR-Vs is an important research focus in CRPC. Contrasting views and emphasis, each supported by data, were presented at the meeting, discussed among the participants, and synthesized in this report. CONCLUSIONS: This article highlights the state of knowledge and outlines the most pressing questions that need to be addressed to advance the AR-V field. PATIENT SUMMARY: Although further investigation is needed to delineate the role of androgen receptor (AR) variants in metastatic castration-resistant prostate cancer, advances in measurement science have enabled development of blood-based tests for treatment selection. Detection of AR variants (eg, AR-V7) identified a patient population with poor outcomes to existing AR-targeting therapies, highlighting the need for novel therapeutic agents currently under development.
CONTEXT: Although a number of studies have demonstrated the importance of constitutively active androgen receptor variants (AR-Vs) in prostate cancer, questions still remain about the precise role of AR-Vs in the progression of castration-resistant prostate cancer (CRPC). OBJECTIVE: Key stakeholders and opinion leaders in prostate cancer convened on May 11, 2017 in Boston to establish the current state of the field of AR-Vs. EVIDENCE ACQUISITION: The meeting "Mission Androgen Receptor Variants" was the second of its kind sponsored by the Prostate Cancer Foundation (PCF). This invitation-only event was attended by international leaders in the field and representatives from sponsoring organizations (PCF and industry sponsors). Eighteen faculty members gave short presentations, which were followed by in-depth discussions. Discussions focused on three thematic topics: (1) potential of AR-Vs as biomarkers of therapeutic resistance; (2) role of AR-Vs as functionally active CRPC progression drivers; and (3) utility of AR-Vs as therapeutic targets in CRPC. EVIDENCE SYNTHESIS: The three meeting organizers synthesized this meeting report, which is intended to summarize major data discussed at the meeting and identify key questions as well as strategies for addressing these questions. There was a critical consensus that further study of the AR-Vs is an important research focus in CRPC. Contrasting views and emphasis, each supported by data, were presented at the meeting, discussed among the participants, and synthesized in this report. CONCLUSIONS: This article highlights the state of knowledge and outlines the most pressing questions that need to be addressed to advance the AR-V field. PATIENT SUMMARY: Although further investigation is needed to delineate the role of androgen receptor (AR) variants in metastatic castration-resistant prostate cancer, advances in measurement science have enabled development of blood-based tests for treatment selection. Detection of AR variants (eg, AR-V7) identified a patient population with poor outcomes to existing AR-targeting therapies, highlighting the need for novel therapeutic agents currently under development.
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