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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Treatment and resistance mechanisms in castration-resistant prostate cancer: new implications for clinical decision
Valentina Norz1, Steffen Rausch1
1Department of Urology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany.
Abstract:
Introduction: The armamentarium of treatment options in metastatic and non-metastatic CRPC is rapidly evolving. However, the question of how individual treatment decisions should be balanced by available predictive clinical parameters, pharmacogenetic and drug interaction profiles, or compound-associated molecular biomarkers is a major challenge for clinical practice.Areas covered: We discuss treatment and resistance mechanisms in PC with regard to their association to drug efficacy and tolerability. Current efforts of combination treatment and putative predictive biomarkers of available and upcoming compounds are highlighted with regard to their implication on clinical decision-making.Expert opinion: Several treatment approaches are delineated, where identification of resistance mechanisms in CRPC may guide treatment selection. To date, most of these candidate biomarkers will however be found only in a small subset of patients. While current approaches of combination treatment in CRPC are proving synergistic effects on cancer biology, higher complexity with regard to biomarker analysis and interaction profiles of the respective compounds may be expected. Among other aspects of personalized treatment, consideration of drug-drug interaction and pharmacogenetics is an underrepresented issue. However, the non-metastatic castration resistant prostate cancer situation may be an example for treatment selection based on drug interaction profiles in the future.
Insights
Personalized treatment for castration-resistant prostate cancer (CRPC) is evolving. Balancing treatment decisions requires integrating predictive biomarkers, pharmacogenetics, and drug interactions for improved efficacy and tolerability.
Area of Science:
- Oncology
- Pharmacology
- Genetics
Background:
- Treatment options for metastatic and non-metastatic castration-resistant prostate cancer (CRPC) are rapidly advancing.
- Clinical decision-making faces challenges in balancing individual treatments with predictive parameters, pharmacogenetics, and molecular biomarkers.
Purpose of the Study:
- To discuss treatment and resistance mechanisms in prostate cancer (PC) concerning drug efficacy and tolerability.
- To highlight current combination treatment strategies and predictive biomarkers for clinical decision-making in PC.
- To emphasize the underrepresented role of drug-drug interactions and pharmacogenetics in personalized PC treatment.
Main Methods:
- Review of current literature on CRPC treatment, resistance mechanisms, and predictive biomarkers.
- Analysis of emerging combination therapies and their impact on cancer biology.
- Discussion of pharmacogenetic and drug interaction profiles relevant to PC treatment selection.
Main Results:
- Identification of resistance mechanisms in CRPC can guide treatment selection, though candidate biomarkers are often found in a small patient subset.
- Combination treatments show synergistic effects on cancer biology but increase complexity in biomarker analysis and compound interactions.
- Drug-drug interactions and pharmacogenetics are crucial yet underrepresented factors in personalized PC treatment.
Conclusions:
- Future treatment selection in CRPC, particularly non-metastatic cases, may increasingly rely on drug interaction profiles.
- Personalized medicine in CRPC necessitates a comprehensive approach considering biomarkers, pharmacogenetics, and drug interactions for optimal outcomes.
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