Spratt Daniel E, Zumsteg Zachary S, Feng Felix Y, Tomlins Scott A
Department of Radiation Oncology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109, USA.
Department of Radiation Oncology, Cedars Sinai Medical Center, 8700 Beverly Blvd, West Hollywood, CA 90048, USA.
Nat Rev Clin Oncol. 2016 Oct;13(10):597-610. doi: 10.1038/nrclinonc.2016.76. Epub 2016 Jun 1.
Over the past several years, analyses of data from high-throughput studies have elucidated many fundamental insights into prostate cancer biology. These insights include the identification of molecular alterations and subtypes that drive tumour progression, recurrent aberrations in signalling pathways, the existence of substantial intertumoural and intratumoural heterogeneity, Darwinian evolution in response to therapeutic pressures and the complicated multidirectional patterns of spread between primary tumours and metastatic sites. However, these concepts have not yet been fully translated into clinical tools to improve prognostication, prediction and personalization of treatment of patients with prostate cancer. The current and future clinical implications of 'omics' level knowledge is not only revolutionizing our understanding of prostate cancer biology, but is also shaping ongoing, and future clinical investigations and practice. In this Review, we summarize these advances, and the remaining challenges surrounding tumour heterogeneity and the ability to overcome treatment resistance are also described.
在过去几年中，对高通量研究数据的分析阐明了许多关于前列腺癌生物学的基本见解。这些见解包括识别驱动肿瘤进展的分子改变和亚型、信号通路中的反复畸变、肿瘤间和肿瘤内存在的显著异质性、对治疗压力的达尔文式进化以及原发性肿瘤与转移部位之间复杂的多向扩散模式。然而，这些概念尚未完全转化为临床工具，以改善前列腺癌患者的预后、预测和个性化治疗。“组学”水平知识的当前和未来临床意义不仅正在彻底改变我们对前列腺癌生物学的理解，也正在塑造当前和未来的临床研究及实践。在本综述中，我们总结了这些进展，并描述了围绕肿瘤异质性以及克服治疗耐药性能力的剩余挑战。
