Raoul S. Concepcion, MD, FACS, presented “AR Resistance Mechanisms: Focusing on Variants and Testing” during the 29th Annual International Prostate Cancer Update on January 26, 2019 in Beaver Creek, Colorado.

How to cite: Concepcion, Raoul S. “AR Resistance Mechanisms: Focusing on Variants and Testing” January 26, 2019. Accessed Nov 2024. https://grandroundsinurology.com/ar-resistance-mechanisms-focusing-on-variants-and-testing/

New Considerations for Oligometastatic Prostate Cancer – Summary: 

Raoul S. Concepcion, MD, FACS, reviews the role of androgen receptor (AR) resistance mechanisms in recently-approved drugs for metastatic castration-resistant prostate cancer (mCRPC) and disease progression. He then emphasizes the need for better predictive and prognostic biomarkers and the optimization of therapeutic choices.

Abstract: 

Over the last decade, there have been many advancements in treatment for patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC). Several drugs that prolong overall survival in these patients, such as docetaxel, cabazitaxel, abiraterone, enzalutamide, and radium-223, are now approved. However, exposure to these newer targeted agents, especially as physicians prescribe them earlier in the disease state, will present significant subsequent consequences. 

Drug resistance, which consequently allows for the progression of disease, is a result of mutations by cell lines and treatment pressure selection. Pharmacogenetics, or the understanding of how one’s genetic makeup can predict the response to certain drugs, plays an integral part of precision medicine. This concept forms the basis in the development of predictive biomarkers, which are sorely needed for the management of advanced prostate cancers.

This presentation will review mechanisms of resistance and how the application of this knowledge can inform biomarker testing to optimize therapy for patients with progressive disease.

About the International Prostate Cancer Update

The International Prostate Cancer Update (IPCU) is an annual, multi-day CME conference focused on prostate cancer treatment updates. The conference’s faculty consists of international experts, and the event caters to urologists, medical oncologists, radiation oncologists, and other healthcare professionals. Topics encompass prostate cancer management, from diagnosis to treating advanced and metastatic disease. Dr. Concepcion presented this lecture during the 29th IPCU in 2019. Please visit this page in order to learn more about future IPCU meetings.

ABOUT THE AUTHOR

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Raoul S. Concepcion, MD, FACS, is the Chief Science Officer of U.S. Urology Partners in Nolensville, Tennessee. He was a resident in General Surgery and Urology at Vanderbilt University from 1984-1990, and later served as a Clinical Associate Professor of Urology there.

Dr. Concepcion’s clinical interests revolve around advanced prostate and bladder cancer management. He is a past President of LUGPA. Along with two other urologists, he founded CUSP, a urologic research consortium in the United States. Additionally, he is an advisor and/or speaker for many companies, including Dendreon, Pfizer, Astellas, Amgen, Cellay, and Janssen, and has served as editor for Urologists in Cancer Care.