The biology of hormone refractory breast and prostate cancer An NCI workshop report

The molecular regulation of growth and progression of hormone refractory breast and prostate cancers remains challenging. The Division of Cancer Biology, NCI organized a small "think tank" style workshop and invited scientists in relevant areas to assess the state of science on the biology of hormone refractory tumors and to identify potential research opportunities to enhance a better understanding of the molecular regulation of these tumors. The meeting, held on May 27-29, 2008 in Bethesda, MD, was co-chaired by Drs. Michael Geoffrey Rosenfeld and Michael Press. While expression of estrogen or progesterone receptors (ER/PR) is required for benefit from endocrine manipulations, many women with breast cancer will not respond to primary endocrine manipulations despite ER/PR expression, and others acquire resistance while on treatment. Understanding the mechanisms that lead to Hormone Refractory Breast Cancer (HRBC) and defining interventions that may modulate the resistance to endocrine therapy are currently lacking. In contrast to breast cancers, the vast majority of both early and advanced prostate carcinomas exhibit androgen-pathway activity at diagnosis and the vast majority respond to treatments designed to inhibit AR-signaling. However, after initial benefit, advanced prostate cancers regularly progress to a clinical state termed Castration Resistant Prostate Cancer (CRPC) that reflects a diverse array of molecular events maintaining AR signaling. The workshop focused on both common and unique features of hormone refractory breast and prostate cancer with an orientation toward defining major research questions, delineating opportunities and recommending strategies for overcoming barriers to progress in understanding these important clinical disease states.