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Identification de nouvelles cibles thérapeutiques dans le cancer de la prostate

Abstract : In France, prostate cancer is the most frequently diagnosed male cancer and its progression is tightly associated with the androgen signals. One of the major treatments for prostate cancer is androgen deprivation therapy which is based on blocking the production or action of the androgens to induce a tumor growth inhibition. Most patients respond to this therapy, however they still reach a castration-resistant stage which is associated with a poor prognosis. Since the progression till this late cancer stage is still driven by the androgen signaling pathway, the second-line therapy is focused on targeting the active androgen receptor by using a second-generation anti-androgens: the Enzalutamide. This molecule disrupts the interaction between the androgen receptor and its ligand, it can block the nuclear translocation of the receptor and it also prevents the receptor interaction with DNA. Although Enzalutamide treatment has enhance the patient survival, some drug resistance still arises which is a considerable therapeutic challenge.The main objective of my thesis is to identify new proteins in order to improve the therapeutic effects of Enzalutamide or to overcome resistance to this drug. Thus, in our study, we assumed that Enzalutamide treatment induces the activation of specific signaling pathways which may be involved in the cancer cell response to the treatment. This hypothesis led us to identify the MAPKs p38 proteins, which are activated during treatment with Enzalutamide. Our results show that the combination of Enzalutamide and p38 inhibitor has a significant antitumor effect both in vitro and in vivo. The mechanism of action of this cytotoxic and synergistic effect remains under study. These data would allow a better understanding of the Enzalutamide resistance mechanisms and contribute to the enhancement of the therapeutic effect of this anti-androgen.
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Valomanda Rakotondrahaso. Identification de nouvelles cibles thérapeutiques dans le cancer de la prostate. Médecine humaine et pathologie. Université Montpellier, 2019. Français. ⟨NNT : 2019MONTT023⟩. ⟨tel-02464850⟩

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