Giunta Emilio Francesco, Annaratone Laura, Bollito Enrico, Porpiglia Francesco, Cereda Matteo, Banna Giuseppe Luigi, Mosca Alessandra, Marchiò Caterina, Rescigno Pasquale
Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Cancers (Basel). 2021 Sep 24;13(19):4771. doi: 10.3390/cancers13194771.
Prostate cancer (PCa) therapy has been recently revolutionized by the approval of new therapeutic agents in the metastatic setting. However, the optimal therapeutic strategy in such patients should be individualized in the light of prognostic and predictive molecular factors, which have been recently studied: androgen receptor (AR) alterations, PTEN-PI3K-AKT pathway deregulation, homologous recombination deficiency (HRD), mismatch repair deficiency (MMRd), and tumor microenvironment (TME) modifications. In this review, we highlighted the clinical impact of prognostic and predictive molecular factors in PCa patients' outcomes, identifying biologically distinct subtypes. We further analyzed the relevant methods to detect these factors, both on tissue, i.e., immunohistochemistry (IHC) and molecular tests, and blood, i.e., analysis of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). Moreover, we discussed the main pros and cons of such techniques, depicting their present and future roles in PCa management, throughout the precision medicine era.
近期，转移性前列腺癌（PCa）治疗因新型治疗药物获批而发生了变革。然而，鉴于近期已开展研究的预后和预测分子因素，此类患者的最佳治疗策略应实现个体化，这些因素包括：雄激素受体（AR）改变、PTEN-PI3K-AKT通路失调、同源重组缺陷（HRD）、错配修复缺陷（MMRd）以及肿瘤微环境（TME）改变。在本综述中，我们强调了预后和预测分子因素对PCa患者预后的临床影响，识别出生物学上不同的亚型。我们进一步分析了检测这些因素的相关方法，包括在组织上进行的检测，即免疫组织化学（IHC）和分子检测，以及在血液中进行的检测，即循环肿瘤细胞（CTC）和循环肿瘤DNA（ctDNA）分析。此外，我们讨论了这些技术的主要优缺点，描述了它们在整个精准医学时代PCa管理中的当前和未来作用。
