Advances in spatial omics for the analysis of prostate cancer

Prostate cancer is one of the most common malignancies in men and is marked by extensive clinical and molecular heterogeneity. Although genomic and transcriptomic studies have revealed recurrent alterations and lineage plasticity, these approaches lack spatial resolution and therefore cannot capture the microenvironmental context that underpins tumor progression and therapeutic resistance. Spatial omics technologies have emerged as transformative tools by integrating high-dimensional molecular profiling with preserved tissue architecture. Advances in spatial transcriptomics, proteomics, epigenomics, and metabolomics now permit the mapping of gene expression, protein signaling, chromatin accessibility, modifications, and folding, along with metabolic gradients at cellular to subcellular resolution. Spatial analysis of prostate cancer has revealed key features of disease progression, including stromal remodeling, immune evasion, lipid metabolic rewiring, and therapy-resistant niches. This review highlights recent spatial omics technologies, their emerging integrative and clinical applications in prostate cancer, and the future challenges in standardization, data integration, and clinical translation.