Abiraterone and enzalutamide in castration resistant prostate cancer lead to drug resistance.
Intrinsic drug resistance arises due to allelic variants in organic anion transporters and HSD3B1.
Acquired drug resistance arises due to intratumoral androgen biosynthesis and changes in the AR.
Acquired resistance can involve the induction of AKR1C3 and emergence of AR-splice variants.
AKR1C3 inhibitors or peptidomimetics that block AR-splice variants may surmount drug resistance.