An F876L mutation in androgen receptor confers genetic and phenotypic resistance to MDV3100 (enzalutamide) - Abstract

Castration-resistant prostate cancer (CRPC) is the most aggressive, incurable form of prostate cancer.

MDV3100 (enzalutamide), an antagonist of the androgen receptor (AR), was approved for clinical use in men with metastatic CRPC. Although this compound showed clinical efficacy, many initial responders later developed resistance. To uncover relevant resistant mechanisms, we developed a model of spontaneous resistance to MDV3100 in LNCaP prostate cancer cells. Detailed characterization revealed that emergence of an F876L mutation in AR correlated with blunted AR response to MDV3100 and sustained proliferation during treatment. Functional studies confirmed that ARF876L confers an antagonist-to-agonist switch that drives phenotypic resistance. Finally, treatment with distinct antiandrogens or cyclin-dependent kinase (CDK)4/6 inhibitors effectively antagonized ARF876L function. Together, these findings suggest that emergence of F876L may (i) serve as a novel biomarker for prediction of drug sensitivity, (ii) predict a "withdrawal" response to MDV3100, and (iii) be suitably targeted with other antiandrogens or CDK4/6 inhibitors.

Written by:
Korpal M, Korn JM, Gao X, Rakiec DP, Ruddy DA, Doshi S, Yuan J, Kovats SG, Kim S, Cooke VG, Monahan JE, Stegmeier F, Roberts TM, Sellers WR, Zhou W, Zhu P.   Are you the author?
Oncology Disease Area, Department of Oncology Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge; and Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.

Reference: Cancer Discov. 2013 Aug 23. Epub ahead of print.
doi: 10.1158/2159-8290.CD-13-0142

PubMed Abstract
PMID: 23842682 Investigative Urology Section