ejolsThe Eurasian Journal of Life SciencesЕвразийский журнал наук о жизни3033-54933033-6031Сеченовский Университет10.47093/3033-5493.2026.2.1.3-27ejols-46Research ArticlePrecision OncologyПрецизионная онкологияAndrogen deprivation therapy for prostate cancer: from mechanism of action, complications and challenges to future prospectsАндрогендепривационная терапия рака предстательной железы: от механизма действия, осложнений и проблем до будущих перспективhttps://orcid.org/0009-0009-2846-6711ЛиЦ.LiJ.

Цзяминь Ли, PhD, профессор, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Jiamin Li, PhD, Professor, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0000-0003-3770-7504ТугузбаеваГ.TuguzbaevaG.

Гульнара Тугузбаева, PhD, исполняющая обязанности заведующей кафедрой и доцент кафедры патологической физиологии

ул. Ленина, 3, Уфа, 450008

Gulnara Tuguzbaeva, PhD, Acting Head and Associate Professor, Department of Pathophysiology

3, Lenina str., Ufa, 450008

https://orcid.org/0009-0004-1016-4081ЮаньЕYuanY.

Е Юань, магистрант, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Ye Yuan, MSc Candidate, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0009-0004-8101-3862ЛуЯ.LUY.

Яцин Лу, магистрант, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Yaqing LU, MSc Candidate, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0009-0009-9935-9956ЛюС.LiuS.

Сыци Лю, магистрант, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Siqi Liu, MSc Candidate, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy,

157, Baojian Road, Harbin, 150081, China

https://orcid.org/0009-0003-4360-0014СюнЦ.XiongJ.

Цзяци Сюн, студентка бакалавриата, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Jiaqi Xiong, Undergraduate Student, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0009-0002-5389-1073ЧжанЧ.ZhangZ.

Чжэнь Чжан, аспирант, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Zhen Zhang, PhD Candidate, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0000-0002-4657-6625УрманцевМ.UrmantsevM.

Марат Урманцев, PhD, доцент кафедры урологии и онкологии

ул. Ленина, 3, Уфа, 450008

Marat Urmantsev, PhD, Associate Professor, Department of Urology and Oncology

3, Lenina str., Ufa, 450008

https://orcid.org/0000-0003-2202-7071ЩекинВ.ShchekinV.

Влас Щекин, PhD, главный исследователь научно-морфологической лаборатории Института фундаментальной медицины

ул. Ленина, 3, Уфа, 450008

Vlas Shchekin, PhD, Principal investigator of the Morphological Laboratory, Institute of Fundamental Medicine

3, Lenina str., Ufa, 450008

https://orcid.org/0000-0001-8431-280XАкинйемиС. О.AkinyemiS. O.

Самуэль Олалекан Акинйеми, MD, ассистент кафедры урологии и онкологии

ул. Ленина, 3, Уфа, 450008

Samuel Olalekan Akinyemi, MD, Assistant lecturer, Department of Urology and Oncology,

3, Lenina str., Ufa, 450008

https://orcid.org/0009-0008-1482-8104ТаньХ.TanH.

Тань Хуэйпин, заместитель начальника отдела, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Huiping Tan, Deputy Section Chief, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0000-0002-7243-6968ВанН.WangN.

Ван Нин, PhD, профессор, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Ning Wang, PhD, Professor, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

https://orcid.org/0000-0003-2125-4897ПавловВ.PavlovV.

Валентин Павлов, академик РАН, доктор медицинских наук, ректор, профессор, заведующий кафедрой урологии и онкологии

ул. Ленина, 3, Уфа, 450008

Valentin Pavlov, PhD, Professor, Academician of the Russian Academy of Science, Rector, Professor, Department of Urology and Oncology

3, Lenina str., Ufa, 450008

https://orcid.org/0000-0002-0125-1608ЯнБ.YangB.

Ян Баофэн, PhD, профессор, Государственная ключевая лаборатория сердечно-сосудистых заболеваний холодных регионов (SKLFZCD), ключевая лаборатория сердечно-сосудистых исследований Министерства образования, кафедра фармакологии, ключевая лаборатория фармакологии, фармацевтический колледж

ул. Баоцзянь, 157, Харбин, 150081

Baofeng Yang, PhD, Professor, State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, Key Laboratory of Pharmacology, College of Pharmacy

157, Baojian Road, Harbin, 150081

yangbf@ems.hrbmu.edu.cnХарбинский медицинский университетКитайHarbin Medical UniversityChinaБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation20260707202621327Copyright © Li J., Tuguzbaeva G., Yuan Y., LU Y., Liu S., Xiong J., Zhang Z., Urmantsev M., Shchekin V., Akinyemi S., Tan H., Wang N., Pavlov V., Yang B., 20262026Ли Ц., Тугузбаева Г., Юань Е., Лу Я., Лю С., Сюн Ц., Чжан Ч., Урманцев М., Щекин В., Акинйеми С., Тань Х., Ван Н., Павлов В., Ян Б.Li J., Tuguzbaeva G., Yuan Y., LU Y., Liu S., Xiong J., Zhang Z., Urmantsev M., Shchekin V., Akinyemi S., Tan H., Wang N., Pavlov V., Yang B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.eajls.com/jour/article/view/46

Prostate cancer ranks among the most prevalent malignancies in men, with disease progression driven by sustained androgen receptor (AR) signaling. Androgen deprivation therapy (ADT), which suppresses androgen synthesis and AR activation, serves as the standard treatment for advanced disease. ADT modalities include surgical castration, gonadotropin-releasing hormone agonists/antagonists, anti-androgens, and androgen synthesis inhibitors. Despite initial efficacy, long-term ADT is frequently complicated by the emergence of castration-resistant prostate cancer (CRPC) and multi-system toxicities involving metabolic, cardiovascular, and skeletal systems. CRPC arises from AR reactivation via gene amplification, mutation, splice variants and crosstalk with oncogenic pathways. Contemporary treatment intensification combines ADT with next-generation AR inhibitors, chemotherapy, and immunotherapy. Predictive biomarkers such as AR variant 7 and homeobox B13 facilitate patient stratification and individualized treatment decisions. The aim of this review is to summarize the role of ADT in prostate cancer management, with particular emphasis on androgen metabolism, AR signaling, mechanisms of castration resistance, ADT-related complications, and emerging therapeutic strategies. Based on systematic literature retrieval from PubMed and Embase (2018–2025), this review synthesizes current knowledge on androgen metabolism, AR signaling, CRPC mechanisms, ADT-related complications, and emerging therapeutic strategies to optimize long-term outcomes.

Рак предстательной железы относится к числу наиболее распространенных злокачественных новообразований у мужчин, а прогрессирование заболевания во многом определяется устойчивой активацией сигнального пути андрогенного рецептора (АР). Андрогендепривационная терапия (АДТ), направленная на подавление синтеза андрогенов и активации АР, является стандартным методом лечения. К методам АДТ относят хирургическую кастрацию, назначение агонистов/антагонистов гонадотропин-рилизинг-гормона, антиандрогенов и ингибиторов синтеза андрогенов. Несмотря на первоначальную эффективность, длительная АДТ часто осложняется развитием кастрационно-резистентного рака предстательной железы (КРРПЖ) и мультисистемной токсичностью с вовлечением метаболической, сердечно-сосудистой и костной систем. КРРПЖ развивается вследствие реактивации АР за счет амплификации генов, мутаций, вариантов сплайсинга и перекрестного взаимодействия с онкогенными сигнальными путями. Современная интенсификация лечения предполагает сочетание АДТ с ингибиторами АР нового поколения, химиотерапией и иммунотерапией. Предиктивные биомаркеры, такие как АР вариант 7 и гомеобокс B13, способствуют стратификации пациентов и принятию индивидуализированных терапевтических решений. Целью обзора является обобщение роли АДТ в лечении рака предстательной железы с особым акцентом на метаболизм андрогенов, сигнальный путь АР, механизмы кастрационной резистентности, осложнения, связанные с АДТ, и новые терапевтические стратегии. На основе систематического поиска литературы в PubMed и Embase за 2018–2025 г обобщены современные данные о метаболизме андрогенов, сигнальном пути АР, механизмах КРРПЖ, осложнениях, связанных с АДТ, и новых терапевтических стратегиях, направленных на оптимизацию долгосрочных результатов лечения.

кастрационно-резистентный рак предстательной железысигнальный путь андрогенного рецептораосложнения леченияпрецизионная онкологияпредиктивные биомаркерыcastration-resist ant prostate cancerandrogen receptor signalingtreatment complicationsprecision oncologypredictive biomarkersThis work was supported by the Key Regional Joint Projects of the National Natural Science Foundation of China [Grant No. U25A2006], the National Natural Science Foundation of China [Grant No. 82370328 to JML; Grant No. 82570382 to JML] and BSMU Strategic Academic Leadership Program [PRIORITY-2030 to GT].ReferencesKratzer TB, Mazzitelli N, Star J, Dahut WL, Jemal A, Siegel RL. Prostate cancer statistics, 2025. CA A Cancer J Clinicians. 2025;75(6):485–497. doi: 10.3322/caac.70028Kratzer TB, Mazzitelli N, Star J, Dahut WL, Jemal A, Siegel RL. Prostate cancer statistics, 2025. CA A Cancer J Clinicians. 2025;75(6):485–497. doi: 10.3322/caac.70028Schafer EJ, Laversanne M, Sung H, et al. 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The authors declare that there are no conflicts of interest present.