Question 1

What is the Meaning of Enzalutamide Resistance?

Accepted Answer

Enzalutamide resistance refers to the clinical phenomenon where prostate cancer cells, initially responsive to the androgen receptor inhibitor enzalutamide, develop mechanisms that render them unresponsive to the drug's therapeutic effects, leading to disease progression. This represents a significant challenge in managing advanced prostate cancer, requiring careful clinical consideration.

Question 2

What is the Context of Enzalutamide Resistance?

Accepted Answer

This resistance occurs within the complex landscape of metastatic castration-resistant prostate cancer, a stage where the disease continues to progress despite androgen deprivation therapy. Enzalutamide specifically targets the androgen receptor signaling pathway, crucial for prostate cancer cell growth and survival, by inhibiting multiple steps of the pathway within the cellular environment.

Question 3

What is the Significance of Enzalutamide Resistance?

Accepted Answer

The development of enzalutamide resistance profoundly impacts patient care, manifesting as rising prostate-specific antigen levels, symptomatic deterioration, and radiographic evidence of tumor growth. It necessitates a critical re-evaluation of treatment strategies, often leading to a switch to alternative systemic therapies to mitigate disease progression and preserve quality of life for the individual.

Question 4

What is the Mechanism of Enzalutamide Resistance?

Accepted Answer

Resistance often arises through several molecular alterations, including but not limited to, androgen receptor gene amplification, point mutations within the androgen receptor, or the expression of constitutively active androgen receptor splice variants like AR-V7. Other mechanisms involve the activation of alternative signaling pathways or lineage plasticity, allowing cancer cells to circumvent androgen receptor inhibition and continue proliferating.

Question 5

What is the Application of Enzalutamide Resistance?

Accepted Answer

In clinical practice, the emergence of enzalutamide resistance is typically recognized by observing a sustained rise in serum prostate-specific antigen despite continued enzalutamide therapy, often accompanied by new or worsening symptoms or findings on diagnostic imaging. This clinical progression guides the decision-making process for subsequent lines of systemic treatment, aiming to control disease burden and manage patient well-being.

Question 6

What is the Metric of Enzalutamide Resistance?

Accepted Answer

Resistance to enzalutamide is primarily monitored through serial measurements of serum prostate-specific antigen (PSA) levels, which typically increase as the disease progresses beyond control. Radiographic imaging, such as CT scans and bone scans, is also crucial for assessing tumor burden and metastatic spread. In some cases, circulating tumor DNA analysis can identify specific resistance-driving mutations or splice variants, offering molecular insights.

Question 7

What is the Risk of Enzalutamide Resistance?

Accepted Answer

The primary risk associated with enzalutamide resistance is the uncontrolled progression of metastatic prostate cancer, which can lead to increased tumor-related symptoms such as bone pain, pathological fractures, and organ compression. This progression significantly impacts patient morbidity and mortality, underscoring the urgent need for effective subsequent therapeutic options to maintain health and function.

Enzalutamide Resistance

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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