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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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Updated: Jan 13, 2026

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Neoadjuvant Therapies for Prostate Cancer-Current Paradigms and Future Directions.

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  • 1Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, VIC 3000, Australia.

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Summary
This summary is machine-generated.

Neoadjuvant therapies for high-risk prostate cancer are evolving. Newer treatments like androgen receptor pathway inhibitors and radioligand therapy show promise for improving survival and personalized treatment strategies.

Keywords:
ADTARPIsneoadjuvant therapyprostate cancerradioligand therapy

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Area of Science:

  • Oncology
  • Urology
  • Medical Physics

Background:

  • High-risk and locally advanced prostate cancer have high recurrence and mortality rates.
  • The neoadjuvant period offers a critical window for systemic therapy before radical prostatectomy or radiotherapy.
  • Previous neoadjuvant therapies, including first-generation androgen deprivation therapy (ADT) and docetaxel-based regimens, showed limited survival benefits.

Purpose of the Study:

  • To review current evidence on neoadjuvant therapies for high-risk prostate cancer.
  • To explore emerging systemic treatments and future research directions in the neoadjuvant setting.

Main Methods:

  • This is a narrative review synthesizing existing clinical trial data and research findings.
  • Focus on evaluating the efficacy and outcomes of various neoadjuvant systemic therapies.
  • Discussion of ongoing phase III trials and novel therapeutic approaches.

Main Results:

  • Second-generation androgen receptor pathway inhibitors (ARPIs) combined with ADT demonstrate significant survival benefits in metastatic settings and are under investigation in neoadjuvant trials.
  • [177Lu]Lu-PSMA-617 radioligand therapy shows promise in the neoadjuvant setting.
  • Radiotherapy (RT) alone faces challenges in eradicating micrometastatic disease, similar to surgery, driving interest in intensified neoadjuvant systemic therapy.

Conclusions:

  • Neoadjuvant ARPIs and radioligand therapies represent promising advancements for high-risk prostate cancer.
  • Future research will focus on personalized neoadjuvant strategies incorporating genomic and molecular profiling.
  • Identifying immunologically responsive subtypes may guide the use of immune-directed therapies in the peri-operative setting.