Galeterone

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Overview[edit | edit source]

Galeterone is an investigational drug that was developed for the treatment of prostate cancer. It is a small molecule that acts as an androgen receptor antagonist, CYP17A1 inhibitor, and androgen receptor degrader. Galeterone was designed to target multiple pathways involved in the progression of castration-resistant prostate cancer (CRPC).

Mechanism of Action[edit | edit source]

Galeterone works through a multi-faceted mechanism:

  • It inhibits the CYP17A1 enzyme, which is crucial for the synthesis of androgens. By inhibiting this enzyme, galeterone reduces the production of androgens that can stimulate prostate cancer growth.
  • It acts as an antagonist to the androgen receptor, blocking the binding of androgens to the receptor and thereby inhibiting the androgen receptor signaling pathway.
  • It promotes the degradation of the androgen receptor, reducing the number of receptors available for activation by androgens.

Development and Clinical Trials[edit | edit source]

Galeterone was developed by Tokai Pharmaceuticals and underwent several phases of clinical trials. The drug showed promise in early-stage trials, particularly in patients with specific genetic mutations such as AR-V7, a splice variant of the androgen receptor that is associated with resistance to other therapies.

Chemical structure of Galeterone

However, in later-stage clinical trials, galeterone did not demonstrate sufficient efficacy compared to existing treatments, leading to the discontinuation of its development for prostate cancer.

Potential Benefits and Challenges[edit | edit source]

The potential benefits of galeterone included its ability to target multiple mechanisms of androgen receptor signaling, which could theoretically overcome resistance seen with other therapies that target only one aspect of the pathway.

Challenges in the development of galeterone included the complexity of its mechanism of action and the need to demonstrate clear clinical benefits over existing therapies such as abiraterone and enzalutamide.

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Contributors: Prab R. Tumpati, MD