Prostate cancer is the most frequently diagnosed cancer and the third leading cause of cancer deaths in males. The prostate consists of epithelial and stromal compartments separated by basement membranes.Prostate cancer (PCa) is a complex multifaceted and biologically heterogeneous disease. The majority of men diagnosed with prostate cancer will benefit from not being treated, because they have low volume indolent tumors that do not require immediate treatment.Prostate cancer is driven by the androgen receptor (AR), a ligand-dependent transcription factor belonging to the nuclear receptor family. In the absence of ligand (e.g., the major androgens dihydrotestosterone (DHT) and testosterone, or other androgenic steroids), the AR is located in the cell cytoplasm, complexed with chaperone proteins. After ligand binding, it translocates into the nucleus, and forms a homodimer following the interaction of dedicated motifs present in the DNA-binding domain (DBD) and the ligand-binding domain (LBD).
The most common known genomic alterations in PCa involve four pathways/genes: the androgen receptor pathway, PI3K pathway, rearrangements that place members of the ETS transcription factor family under control of androgen responsive promoter TMPRSS2, and loss of function of the prostate tumor suppressor NKX3.1.The high prevalence of aberrations in the AR and PI3K/AKT/mTOR signaling pathways has led to several ongoing clinical trials focused on these pathways.

References

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