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Genomic predictors for treatment of late stage prostate cancer
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Journal Article
Genomic predictors for treatment of late stage prostate cancer
2016
Overview
In spite of the development of new treatments for late stage prostate cancer, significant challenges persist to match individuals with effective targeted therapies. Genomic classification using high-throughput sequencing technologies has the potential to achieve this goal and make precision medicine a reality in the management of men with castrate-resistant prostate cancer. This chapter reviews some of the most recent studies that have resulted in significant progress in determining the landscape of somatic genomic alterations in this cohort and, more importantly, have provided clinically actionable information that could guide treatment decisions. This chapter reviews the current understanding of common alterations such as alterations of the androgen receptor and PTEN pathway, as well as ETS gene fusions and the growing importance of PARP inhibition. It also reviews recent studies that characterize the evolution to neuroendocrine tumors, which is becoming an increasingly important clinical problem. Finally, this chapter reviews recent innovative studies that characterize the compelling evolutionary history of lethal prostate cancer evidenced by polyclonal seeding and interclonal cooperation between metastasis and the importance of tumor clone dynamics measured serially in response to treatment. The genomic landscape of late stage prostate cancer is becoming better defined, and the prospect for assigning clinically actionable data to inform rationale treatment for individuals with this disease is becoming a reality.
Publisher
Wolters Kluwer - Medknow Publications,Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Medknow Publications & Media Pvt Ltd,Wolters Kluwer Medknow Publications
Subject
/ Antineoplastic Agents - therapeutic use
/ Biomarkers, Tumor - genetics
/ Biopsy
/ Cloning
/ DNA
/ Genes
/ Genomics
/ Humans
/ Kinases
/ Male
/ Methods
/ Mutation
/ Prostatic Neoplasms - drug therapy
/ Prostatic Neoplasms - genetics
/ Prostatic Neoplasms - pathology
/ Proteins
/ PTEN Phosphohydrolase - genetics
/ Receptors, Androgen - genetics
/ Rodents
/ Studies
/ Tumors
/ 分类技术
/ 前列腺癌
/ 基因组
/ 晚期
/ 治疗
/ 神经内分泌
/ 雄激素受体
/ 预测因子
