Advanced prostate cancer update 2018

The management of advanced prostate cancer today follows a multidisciplinary approach and involves multi-target treatments. The paradigm has shifted from traditional hormonal therapy, surgery and radiation, to the use of chemotherapy, and until recently the development of various immunotherapies and radiopharmaceuticals. Recent advances turn to molecular medicine combining the expertise of molecular pathology and genetics. In this review, germline genetics, advances in castrate-sensitive metastatic disease, androgen receptor alterations, potential new targeted therapy and novel radiopharmaceuticals will be discussed as the newest perspectives for treating prostate cancer. With better staging and new imaging techniques, patients who could be cured by localized treatments and who could benefit from more intensive regimens can be identified. In future, careful patient selection and novel combinations are likely to be required in the management of prostate cancer.