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The article focuses on the androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer. According to the authors, treatment for advanced or metastatic prostate cancer has relied on androgen-deprivation therapy (ADT) for the past 50 years. At present, few treatment options offer effective relief for patients who develop resistance to ADT. Here the authors describe described how prostate cancer growth is stimulated in response to androgens, and consequently how ADT acts to combat this. They also explain how modifications to the androgen receptor (AR) via mutations, amplification and phosphorylation may affect the development of androgen escape.

The article reports that at present there are no effective treatment options for patients who develop androgen escape. Although clinical trials with only antiandrogen therapy improve the quality of life of the patient, it does not alter survival. The development of androgen escape is therefore one of the most significant events in the progression of prostate cancer, resulting in a greater risk of morbidity, and reduced survival. The lack of novel and effective therapies to treat androgen escape is a result of the poor understanding of the molecular mechanisms underlying the development of both the primary disease, and more particularly, those events which drive androgen escape.