Why does hormone-resistant prostate cancer occur and what is its formation mechanism?

At present, the specific mechanism is still unclear. Whether it is early, locally advanced, or metastatic prostate cancer, prostate cancer is very sensitive to endocrine therapy. However, after a period of treatment, it will transform into hormone-resistant prostate cancer at different times, which is commonly known as CRpC metastasis in English. Once CRpC is metastatic, it is very difficult to treat. It should be said that there are not many available means at present: the first is chemotherapy; the second is new endocrine inhibitors. Of course, the price of new endocrine inhibitors was very high in the past, but now they are included in medical insurance. Of course, there are others, such as enzalutamide, immune preparations, etc. However, the current available treatment for CRpC in China is: the first is chemotherapy; the second is abiraterone. There are currently several views on the mechanism of prostate cancer turning into hormone-resistant prostate cancer. Some people believe that it is the insensitivity of the receptor, some believe that it is the activation of the bypass, and of course there are some other views. However, none of them can fully explain how hormone-sensitive prostate cancer turns into hormone-resistant prostate cancer. The specific mechanism needs further research in the future.