Resumen
Metastatic prostate cancer is traditionally treated with androgen deprivation therapy. The introduction of second-generation antiandrogens into clinical practice elicits prolonged responses but also gives rise to mechanisms of resistance that do not rely on androgens. The emergent phenotype of androgen-indifferent prostate cancer is associated with an aggressive, atypical clinical course. The term ?aggressive variant prostate cancer? (AVPC) has been coined in order to separate this phenotype from hormone-responsive tumors. Unfortunately, morphology alone cannot reliably predict virulent behavior. The development of prognostic and predictive biomarkers is therefore crucial. In line with this, research has been focusing on unraveling the biological identity of AVPC. Drawing from the current knowledge about AVPC molecular pathogenesis and evolution, we attempt to identify candidate tissue-based AVPC biomarkers.