Personalised Management of Prostate Cancer

Abstract

Despite recent advances, prostate cancer continues to be a leading cause of cancer-related death among men. While the standard management options of surgery, radiotherapy, and androgen deprivation therapy are well established, there are still significant unmet needs. For example, which patients would best be served by active surveillance at the time of diagnosis versus proceeding with definitive therapy is still not well understood. Additionally, more accurate means of monitoring patients’ responses to therapy and remission statuses following therapy are needed. Since all patients with metastatic disease ultimately progress to castration-resistant prostate cancer, new treatment options for this population are also required. As in other areas of oncology, greater personalisation of care holds the potential for more effective treatment while also reducing the risk of adverse effects and morbidity. This review addresses three topics currently under investigation related to the personalised management of prostate cancer: the use of circulating tumour cells in both diagnosis and treatment at all stages of the disease, the introduction of poly(adenosine diphosphate-ribose) polymerase inhibitors for the treatment of castration-resistant prostate cancer, and the emerging role of genomic assays for risk stratification at the time of diagnosis.