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Androgen Receptor Ligand Binding Domain Mutations in Prostate Cancer Help Lend Credence to Adrenal Annihilation Using CYP11A1 Inhibition

Evan Y. Yu
April 01, 2024

It has been many years since I addressed ligand binding domain (LBD) mutations of the androgen receptor (AR).1  At one time it was felt that these mutations were infrequent drivers of disease pathogenesis.  Yet, the Prostate Cancer Foundation's (PCF) funding of the International Dream Team metastatic biopsy study found AR LBD mutations in 22/150 (14.7%) in those previously treated with docetaxel.2  In the modern era, with greater use of potent androgen and AR inhibiting therapies, such as abiraterone acetate, enzalutamide, apalutamide, and darolutamide, estimates for these AR LBD mutations approximate 20% of previously treated patients with metastatic castration-resistant prostate cancer after receipt of an AR pathway inhibitor.


Dr. Evan Yu, MD

Evan Y. Yu, MD

Evan Yu, a medical oncologist, treats prostate, bladder, and testicular cancer and is passionate about providing a personalized medical approach to a selection of novel therapies as well as understanding biological mechanisms of drug sensitivity and resistance.

Clinical Expertise

Medical Oncology, Translational Research, Novel molecular targeted agents, Biomarkers, Imaging (PET scans, MRI), Bone health.

  • Section Head, Cancer Medicine, Clinical Research Division Fred Hutchinson Cancer Center
  • Medical Director, Clinical Research Support Fred Hutchinson Cancer Research Consortium
  • Professor of Medicine Division of Oncology, Department of Medicine University of Washington School of Medicine Seattle, WA
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