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The importance of personalized medicine in urological cancers
Fatemeh Khatami1, Mandana Hassanzad2,3, Shekoufeh Nikfar4
1Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:
A better understanding of key regulatory pathways involved in cancers has led to the development of molecularly targeted therapies. Molecular profiling based on genomics, proteomics, and metabolomics in tumors provides clinicians with the necessary information to maintain a personalized therapeutic regimen according to the patient's needs. for example, androgen deprivation therapy (ADT) for advanced prostate cancer is one of the earliest forms of targeted therapy and has remained a choice of treatment by physicians. Unfortunately, most patients will eventually become non-responsive to ADT and succumb to the disease. Since the emergence of ADT, the understanding of androgen receptor (AR) signaling and mechanisms driving the resistance to ADT has been significantly improved. Inactivation of the PTEN gene is a common occurrence in prostate cancers and is associated with metastatic potential, androgen independence, and poor prognosis. Several studies over personalized medicine for muscle-invasive and metastatic bladder cancer discussed potential molecular biomarkers which are currently under investigation and based on the excision repair cross-complementing group 1 (ERCC1) gene and its role in tumor development and therapeutic resistance to cytotoxic DNA-damaging chemotherapy and ionizing radiation. In this review, we consider personalized medicine for four urological cancers.
Insights
Personalized medicine advances cancer treatment by targeting molecular pathways. This review explores targeted therapies and biomarkers for urological cancers, including prostate and bladder cancer, improving patient outcomes.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Molecularly targeted therapies are emerging due to a better understanding of cancer regulatory pathways.
- Molecular profiling (genomics, proteomics, metabolomics) enables personalized therapeutic regimens.
- Androgen deprivation therapy (ADT) is an early targeted therapy for advanced prostate cancer, but resistance is common.
Purpose of the Study:
- To review personalized medicine approaches for four major urological cancers.
- To discuss molecular biomarkers and therapeutic resistance mechanisms.
- To highlight advancements in tailoring cancer treatment to individual patient needs.
Main Methods:
- Review of current literature on personalized medicine in urological cancers.
- Analysis of molecular profiling techniques and their clinical applications.
- Examination of resistance mechanisms to targeted therapies, such as ADT.
Main Results:
- PTEN gene inactivation is linked to metastatic potential and androgen independence in prostate cancer.
- ERCC1 gene is investigated as a biomarker for bladder cancer resistance to chemotherapy and radiation.
- Personalized medicine strategies are evolving for various urological malignancies.
Conclusions:
- Understanding molecular pathways is crucial for developing effective targeted therapies.
- Biomarkers play a key role in guiding personalized treatment decisions for urological cancers.
- Continued research into resistance mechanisms will further refine personalized oncology.
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