James L. Mohler, MD, presented “A Better Abiraterone: The Backdoor Pathway for Intracrine Androgen Metabolism” during the 30th Annual International Prostate Cancer Update on January 23rd, 2020 in Beaver Creek, Colorado.


How to cite: Mohler, James L. A Better Abiraterone: The Backdoor Pathway for Intracrine Androgen Metabolism” January 23rd, 2020. Accessed May 2022. https://grandroundsinurology.com/a-better-abiraterone-the-backdoor-pathway-for-intracrine-androgen-metabolism/

A Better Abiraterone: The Backdoor Pathway for Intracrine Androgen Metabolism – Summary:

James L. Mohler, MD, Associate Director and Senior Vice President for Translational Research and Professor of Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, New York, discusses the cause of and potential solutions to androgen receptor expression in castration-recurrent prostate cancer. He explains that prostate cancer tissue in a patient with castration-recurrent disease actually has greater levels of testosterone than benign prostate tissue and that castration-resistant prostate cancer relies on a backdoor pathway of manufacturing testosterone by which dihydrotestosterone (DHT) is made from androstanediol. Abiraterone is intended to inhibit CYP17A1 and therefore prevent the manufacture of DHT, but Dr. Mohler suggests that abiraterone inhibits CYP17A1 that is too far from DHT synthesis to achieve long term response by inhibition. He then discusses current research about  a promising drug that targets the catalytic domain shared by the five  3α-oxidoreductases associated with DHT production.

About The 30th Annual International Prostate Cancer Update:

The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Mohler gave this presentation during the 30th iteration of the meeting in January 2020.

For further educational activities from this conference, visit our collection page.