Targeting CYP17: established and novel approaches in prostate cancer

Curr Opin Pharmacol. 2008 Aug;8(4):449-57. doi: 10.1016/j.coph.2008.06.004. Epub 2008 Jul 28.

Abstract

There is a growing body of evidence that although medical or surgical castration blocks the generation of gonadal testosterone in prostate cancer, androgens originating from other sources may continue to drive androgen receptor (AR) signaling. Recent studies have demonstrated high intratumoral levels of androgens and continued AR signaling in castration-resistant prostate cancer (CRPC), suggesting that androgens may also be synthesized de novo. Inhibiting the systemic biosynthesis of androgens in CRPC by targeting CYP17 may thus represent a rational therapeutic approach since this enzyme catalyses two key steroid reactions involving 17alpha-hydroxylase and C(17,20)-lyase in the androgen biosynthesis pathway. This review will discuss the rationale for and implications of targeting CYP17 in CRPC and focus on established and novel CYP17 inhibitors, including ketoconazole, abiraterone acetate, and VN/124-1, which are agents currently at different stages of development.

Publication types

  • Review

MeSH terms

  • Androgen Receptor Antagonists
  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Clinical Trials as Topic
  • Enzyme Inhibitors / pharmacology
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Male
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / enzymology
  • Receptors, Androgen / biosynthesis
  • Receptors, Androgen / drug effects
  • Steroid 17-alpha-Hydroxylase / antagonists & inhibitors*
  • Steroid 17-alpha-Hydroxylase / biosynthesis
  • Steroid 17-alpha-Hydroxylase / drug effects

Substances

  • Androgen Receptor Antagonists
  • Antineoplastic Agents
  • Enzyme Inhibitors
  • Receptors, Androgen
  • Steroid 17-alpha-Hydroxylase