我们对转移性前列腺癌 (mPCa) 的生物学及其对治疗的反应的理解取得了重大进展。雄激素受体 (AR) 改变，包括突变、扩增、剪接变异和选择性激活，在 mPCa 对治疗的耐药性中发挥着重要作用。最近的研究表明，通过基因组测试检测到的 AR 改变可以被视为男性去势抵抗性 PCa 的预测生物标志物，并可以指导治疗策略。新的治疗方法，包括 AR 拮抗剂和 ACK1、AR N 末端结构域或细胞色素 P450 11A1 抑制剂，已显示出克服治疗耐药性的希望。正在进行的临床试验正在探索这些治疗与 AR 突变状态相关的疗效，并有可能改变 mPCa 的治疗格局。患者摘要：我们的小型综述强调了转移性前列腺癌治疗的进展，重点是针对影响雄激素受体蛋白质的基因改变的药物。已经获得了一些有希望的结果，临床试验正在进行中。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

There have been significant advances in our understanding of the biology of metastatic prostate cancer (mPCa) and its response to therapy. Androgen receptor (AR) alterations, including mutations, amplifications, splice variants, and alternative activations, play a significant role in mPCa resistance to treatment. Recent studies indicate that AR alterations detected via genomic testing can be considered predictive biomarkers in men with castration-resistant PCa and can guide treatment strategies. Novel therapeutic approaches, including AR antagonists and inhibitors of ACK1, the AR N-terminal domain, or cytochrome P450 11A1, have shown promise in overcoming treatment resistance. Ongoing clinical trials are exploring the efficacy of these treatments in relation to AR mutation status and could potentially transform the treatment landscape for mPCa. PATIENT SUMMARY: Our mini review highlights advances in the treatment of metastatic prostate cancer, with a focus on drugs that target genetic alterations affecting a protein called the androgen receptor. Some promising results have been obtained and clinical trials are ongoing.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.