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KV-37 is a potent, isoform-selective, and hydrolytically stable small molecule inhibitor of aldo-keto reductase 1C3 (AKR1C3), also known as type 5 17β-hydroxysteroid dehydrogenase. AKR1C3 is a key enzyme responsible for intratumoral androgen biosynthesis, converting adrenal precursors into testosterone and dihydrotestosterone (DHT), which facilitates the progression of castration-resistant prostate cancer (CRPC). KV-37 reduces androgen receptor (AR) transactivation and prostate-specific antigen (PSA) expression in CRPC cell lines. Preclinical studies demonstrate that KV-37 inhibits prostate cancer cell growth in vitro and in vivo and significantly sensitizes resistant cells to the antitumor effects of enzalutamide, showing a high degree of synergistic drug interaction that can result in a >200-fold potentiation of enzalutamide action.
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