[Molecular pathology of prostate cancer]

Prostate cancer seems to be two diseases: a localized early cancer and a castration-resistant metastatic cancer. While in the localized form the most prevalent genetic alterations are the translocations of the ETS genes, in the castration-resistant form the most prevalent genetic alteration affects androgen receptor and oncosuppressors TP53 and PTEN. The main drivers of the genetic progression of prostate cancer are defects of the DNA-repair systems which are also responsible for the familiar disease. Several prognostic genomic classifiers have been developed and validated clinically which are able to guide management of the early diseases. Today the most useful predictive genetic testing is that of the androgen receptor but others are becoming equally important which can predict taxane resistance.