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Updated: Mar 1, 2026
Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking
Published on: November 17, 2023
Personalizing Therapy for Metastatic Prostate Cancer: The Role of Solid and Liquid Tumor Biopsies
Terence W Friedlander1, Colin C Pritchard1, Himisha Beltran1
1From the Division of Hematology and Medical Oncology, University of California, San Francisco, San Francisco, CA; Department of Laboratory Medicine, University of Washington, Seattle, WA; Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY.
Abstract:
Although biopsies of metastatic prostate cancer are rarely undertaken in the clinical setting, there is increasing interest in developing personalized approaches to therapy by taking into account the genetic and phenotypic changes in an individual tumor. Indeed, analysis of metastatic prostate tumors can predict sensitivity to agents that inhibit DNA repair and resistance to novel hormonal agents, such as abiraterone and enzalutamide, and identify phenotypic changes, such as neuroendocrine differentiation, that have important clinical implications. Although obtaining metastatic tumor tissue is necessary for this genomic and molecular profiling, knowing when to biopsy, selecting the appropriate metastatic lesion, and interpreting the results are major challenges facing clinicians today. In this article, we discuss the rationale for obtaining metastatic tumor tissue, review the bioinformatic approach to analyzing these specimens, discuss the timing and approach to solid and liquid tumor biopsies, review the challenges associated with obtaining and acting on clinically relevant results, and discuss opportunities for the future.
Insights
Biopsying metastatic prostate cancer aids personalized therapy by revealing genetic changes. This analysis predicts treatment response and identifies key tumor characteristics for better clinical management.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Personalized therapy for metastatic prostate cancer requires understanding individual tumor genetics and phenotypes.
- Genomic and molecular profiling of metastatic tumors can predict treatment sensitivity and resistance.
- Phenotypic changes like neuroendocrine differentiation have significant clinical implications.
Purpose of the Study:
- To discuss the rationale for obtaining metastatic prostate cancer tissue for analysis.
- To review bioinformatic approaches for analyzing tumor specimens.
- To explore challenges and future opportunities in metastatic prostate cancer biopsy.
Main Methods:
- Review of current literature on metastatic prostate cancer biopsies.
- Discussion of bioinformatic analysis techniques for genomic and molecular profiling.
- Exploration of solid and liquid biopsy approaches and their clinical application.
Main Results:
- Metastatic tumor analysis can predict response to DNA repair inhibitors and novel hormonal agents (abiraterone, enzalutamide).
- Identification of phenotypic changes, such as neuroendocrine differentiation, is clinically relevant.
- Challenges include determining optimal biopsy timing, lesion selection, and result interpretation.
Conclusions:
- Biopsying metastatic prostate cancer is crucial for personalized treatment strategies.
- Overcoming challenges in biopsy acquisition and interpretation is key to clinical implementation.
- Future research should focus on refining biopsy techniques and bioinformatic analyses.
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