Skip to main content

Advertisement

Log in

Genetic variants in AR and SHBG and resistance to hormonal castration in prostate cancer

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Castration resistance is a life-threatening event that may develop in prostate cancer patients with advanced disease following hormonal castration therapy (HCT). Current understanding of the molecular mechanisms behind resistance to hormonal castration suggests a role for androgen receptor signaling and bioavailability of androgens. We evaluated whether common functional polymorphisms in AR and SHBG genes associate with response to HCT. The study included 203 prostate cancer patients with advanced disease treated with hormonal castration. Genomic DNA was isolated from whole blood, and the genetic polymorphisms AR +1733 G>A and SHBG +5790 G>A were determined by real-time PCR. Genetic variants were associated with response to treatment and time to resistance to hormonal castration. Multivariate analysis showed increased risk of developing resistance to hormonal castration in homozygous GG carriers of the SHBG +5790 G>A (HR = 1.9, 95 % CI 1.1–3.3, P = 0.019) polymorphism alone and when functionally combined with AR +1733 G>A into a high AR pathway activation genetic profile (HR = 1.9, 95 % CI 1.1–3.1, P = 0.015), after adjustment for age, PSA, Gleason’s score and clinical stage. Our results suggest that the SHBG +5790 G>A polymorphism may be a useful marker to include in the pharmacogenomic profile of prostate cancer resistant to hormonal castration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Damber JE, Aus G. Prostate cancer. Lancet. 2008;371(9625):1710–21. doi:10.1016/S0140-6736(08)60729-1.

    Article  PubMed  Google Scholar 

  2. Mottet N, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2011;59(4):572–83. doi:10.1016/j.eururo.2011.01.025.

    Article  PubMed  Google Scholar 

  3. Sharifi N, Gulley JL, Dahut WL. An update on androgen deprivation therapy for prostate cancer. Endocr Relat Cancer. 2010;17(4):R305–15. doi:10.1677/ERC-10-0187.

    Article  PubMed  CAS  Google Scholar 

  4. Goktas S, Crawford ED. Optimal hormonal therapy for advanced prostatic carcinoma. Semin Oncol. 1999;26(2):162–73.

    PubMed  CAS  Google Scholar 

  5. Kantoff PW, Halabi S, Conaway M, Picus J, Kirshner J, Hars V, et al. Hydrocortisone with or without mitoxantrone in men with hormone-refractory prostate cancer: results of the cancer and leukemia group B 9182 study. J Clin Oncol. 1999;17(8):2506–13.

    PubMed  CAS  Google Scholar 

  6. Small EJ, Halabi S, Dawson NA, Stadler WM, Rini BI, Picus J, et al. Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol. 2004;22(6):1025–33. doi:10.1200/JCO.2004.06.037.

    Article  PubMed  CAS  Google Scholar 

  7. Medeiros R, Vasconcelos A, Costa S, Pinto D, Morais A, Oliveira J, et al. Steroid hormone genotypes ARStuI and ER325 are linked to the progression of human prostate cancer. Cancer Genet Cytogenet. 2003;141(2):91–6.

    Article  PubMed  CAS  Google Scholar 

  8. Ross RW, Oh WK, Xie W, Pomerantz M, Nakabayashi M, Sartor O, et al. Inherited variation in the androgen pathway is associated with the efficacy of androgen-deprivation therapy in men with prostate cancer. J Clin Oncol. 2008;26(6):842–7. doi:10.1200/JCO.2007.13.6804.

    Article  PubMed  Google Scholar 

  9. Teixeira AL, Ribeiro R, Cardoso D, Pinto D, Lobo F, Fraga A, et al. Genetic polymorphism in EGF is associated with prostate cancer aggressiveness and progression-free interval in androgen blockade-treated patients. Clin Cancer Res. 2008;14(11):3367–71. doi:10.1158/1078-0432.CCR-07-5119.

    Article  PubMed  CAS  Google Scholar 

  10. Chau CH, Permenter MG, Steinberg SM, Retter AS, Dahut WL, Price DK, et al. Polymorphism in the hypoxia-inducible factor 1alpha gene may confer susceptibility to androgen-independent prostate cancer. Cancer Biol Ther. 2005;4(11):1222–5.

    Article  PubMed  CAS  Google Scholar 

  11. Teixeira AL, Ribeiro R, Morais A, Lobo F, Fraga A, Pina F, et al. Combined analysis of EGF+61G>A and TGFB1+869T>C functional polymorphisms in the time to androgen independence and prostate cancer susceptibility. Pharmacogenomics J. 2009;9(5):341–6. doi:10.1038/tpj.2009.20.

    Article  PubMed  CAS  Google Scholar 

  12. Yang M, Xie W, Mostaghel E, Nakabayashi M, Werner L, Sun T, et al. SLCO2B1 and SLCO1B3 may determine time to progression for patients receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2011;29(18):2565–73. doi:10.1200/JCO.2010.31.2405.

    Article  PubMed  CAS  Google Scholar 

  13. Levy-Nissenbaum E, Bar-Natan M, Frydman M, Pras E. Confirmation of the association between male pattern baldness and the androgen receptor gene. Eur J Dermatol. 2005;15(5):339–40.

    PubMed  CAS  Google Scholar 

  14. Bocchinfuso WP, Ma KL, Lee WM, Warmels-Rodenhiser S, Hammond GL. Selective removal of glycosylation sites from sex hormone-binding globulin by site-directed mutagenesis. Endocrinology. 1992;131(5):2331–6.

    Article  PubMed  CAS  Google Scholar 

  15. Cousin P, Dechaud H, Grenot C, Lejeune H, Pugeat M. Human variant sex hormone-binding globulin (SHBG) with an additional carbohydrate chain has a reduced clearance rate in rabbit. J Clin Endocrinol Metab. 1998;83(1):235–40.

    Article  PubMed  CAS  Google Scholar 

  16. Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59(1):61–71. doi:10.1016/j.eururo.2010.10.039.

    Article  PubMed  Google Scholar 

  17. Scher HI, Halabi S, Tannock I, Morris M, Sternberg CN, Carducci MA, et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol. 2008;26(7):1148–59. doi:10.1200/JCO.2007.12.4487.

    Article  PubMed  Google Scholar 

  18. Cabrespine A, Guy L, Chollet P, Debiton E, Bay JO. Molecular mechanisms involved in hormone resistance of prostate cancer. Bull Cancer. 2004;91(10):747–57.

    PubMed  CAS  Google Scholar 

  19. Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E, et al. American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol. 2004;22(14):2927–41. doi:10.1200/JCO.2004.04.579.

    Article  PubMed  Google Scholar 

  20. Feldman BJ, Feldman D. The development of androgen-independent prostate cancer. Nat Rev Cancer. 2001;1(1):34–45. doi:10.1038/35094009.

    Article  PubMed  CAS  Google Scholar 

  21. Ross RW, Xie W, Regan MM, Pomerantz M, Nakabayashi M, Daskivich TJ, et al. Efficacy of androgen deprivation therapy (ADT) in patients with advanced prostate cancer: association between Gleason score, prostate-specific antigen level, and prior ADT exposure with duration of ADT effect. Cancer. 2008;112(6):1247–53. doi:10.1002/cncr.23304.

    Article  PubMed  Google Scholar 

  22. Gann PH, Hennekens CH, Ma J, Longcope C, Stampfer MJ. Prospective study of sex hormone levels and risk of prostate cancer. J Natl Cancer Inst. 1996;88(16):1118–26.

    Article  PubMed  CAS  Google Scholar 

  23. Stattin P, Lumme S, Tenkanen L, Alfthan H, Jellum E, Hallmans G, et al. High levels of circulating testosterone are not associated with increased prostate cancer risk: a pooled prospective study. Int J Cancer. 2004;108(3):418–24. doi:10.1002/ijc.11572.

    Article  PubMed  CAS  Google Scholar 

  24. Berndt SI, Chatterjee N, Huang WY, Chanock SJ, Welch R, Crawford ED, et al. Variant in sex hormone-binding globulin gene and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2007;16(1):165–8. doi:10.1158/1055-9965.EPI-06-0689.

    Article  PubMed  CAS  Google Scholar 

  25. Low YL, Taylor JI, Grace PB, Mulligan AA, Welch AA, Scollen S, et al. Phytoestrogen exposure, polymorphisms in COMT, CYP19, ESR1, and SHBG genes, and their associations with prostate cancer risk. Nutr Cancer. 2006;56(1):31–9. doi:10.1207/s15327914nc5601_5.

    Article  PubMed  CAS  Google Scholar 

  26. Cunningham JM, Hebbring SJ, McDonnell SK, Cicek MS, Christensen GB, Wang L, et al. Evaluation of genetic variations in the androgen and estrogen metabolic pathways as risk factors for sporadic and familial prostate cancer. Cancer Epidemiol Biomarkers Prev. 2007;16(5):969–78. doi:10.1158/1055-9965.EPI-06-0767.

    Article  PubMed  CAS  Google Scholar 

  27. Haiman CA, Riley SE, Freedman ML, Setiawan VW, Conti DV, Le Marchand L. Common genetic variation in the sex steroid hormone-binding globulin (SHBG) gene and circulating shbg levels among postmenopausal women: the Multiethnic Cohort. J Clin Endocrinol Metab. 2005;90(4):2198–204. doi:10.1210/jc.2004-1417.

    Article  PubMed  CAS  Google Scholar 

  28. Saraon P, Jarvi K, Diamandis EP. Molecular alterations during progression of prostate cancer to androgen independence. Clin Chem. 2011;57(10):1366–75. doi:10.1373/clinchem.2011.165977.

    Article  PubMed  CAS  Google Scholar 

  29. Hoimes CJ, Kelly WK. Redefining hormone resistance in prostate cancer. Ther Adv Med Oncol. 2010;2(2):107–23. doi:10.1177/1758834009356433.

    Article  PubMed  CAS  Google Scholar 

  30. Ribeiro ML, Santos A, Carvalho-Salles AB, Hackel C. Allelic frequencies of six polymorphic markers for risk of prostate cancer. Braz J Med Biol Res. 2002;35(2):205–13.

    PubMed  CAS  Google Scholar 

  31. Irvine RA, Yu MC, Ross RK, Coetzee GA. The CAG and GGC microsatellites of the androgen receptor gene are in linkage disequilibrium in men with prostate cancer. Cancer Res. 1995;55(9):1937–40.

    PubMed  CAS  Google Scholar 

  32. Zhuo FL, Xu W, Wang L, Wu Y, Xu ZL, Zhao JY. Androgen receptor gene polymorphisms and risk for androgenetic alopecia: a meta-analysis. Clin Exp Dermatol. 2012;37(2):104–11. doi:10.1111/j.1365-2230.2011.04186.x.

    Article  PubMed  CAS  Google Scholar 

  33. Lindstrom S, Adami HO, Balter KA, Xu J, Zheng SL, Stattin P, et al. Inherited variation in hormone-regulating genes and prostate cancer survival. Clin Cancer Res. 2007;13(17):5156–61. doi:10.1158/1078-0432.CCR-07-0669.

    Article  PubMed  Google Scholar 

  34. Lindstrom S, Ma J, Altshuler D, Giovannucci E, Riboli E, Albanes D, et al. A large study of androgen receptor germline variants and their relation to sex hormone levels and prostate cancer risk. Results from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium. J Clin Endocrinol Metab. 2010;95(9):E121–7. doi:10.1210/jc.2009-1911.

    Article  PubMed  Google Scholar 

  35. Mononen N, Seppala EH, Duggal P, Autio V, Ikonen T, Ellonen P, et al. Profiling genetic variation along the androgen biosynthesis and metabolism pathways implicates several single nucleotide polymorphisms and their combinations as prostate cancer risk factors. Cancer Res. 2006;66(2):743–7. doi:10.1158/0008-5472.CAN-05-1723.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors acknowledge funding from the Portuguese Foundation for Science and Technology (PTDC/SAL-FCF/71552/2006) and the Portuguese League Against Cancer—North Centre. RR was the recipient of a UICC-ICRETT Fellowship (ICR/10/079/2010). This project was partially sponsored by an unrestricted educational grant for basic research in Molecular Oncology from Novartis Oncology, Portugal.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rui Medeiros.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Monteiro, C., Sousa, M.V., Ribeiro, R. et al. Genetic variants in AR and SHBG and resistance to hormonal castration in prostate cancer. Med Oncol 30, 490 (2013). https://doi.org/10.1007/s12032-013-0490-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-013-0490-2

Keywords

Navigation