Treatment of Castration-Resistant Prostate Cancer

Castration-resistant prostate cancer (CRPC) is a major therapeutic problem. Resistance to androgen deprivation therapy occurs in many patients after initial therapeutic success. The tumor develops genetic and epigenetic mechanisms by which it successfully bypasses the effects of the applied therapy (mutation of the gene for the receptor and enzymes of androgen synthesis, splice forms of the receptor, loss of production of antitumor proteins, and/or increased the creation of proteins that stimulate the formation of tumors, etc.). As for drugs, in CRPC, we have second-generation androgen receptor antagonists such as darolutamide, followed by abiraterone, and newer options like pembrolizumab and olaparib.