Advances in Precision Diagnostics and Personalized Therapeutics for Prostate Cancer: An Integrated Precision...

Area of Science:

• Oncology
• Genetics
• Radiology

Background:

• Precision medicine is transforming prostate cancer (PCa) management.
• Current guidelines advocate for structured diagnostic strategies, advanced imaging, and targeted biomarkers.

Purpose of the Study:

• To review the evidence for precision medicine across the PCa care continuum.
• To propose a decision-node-based framework for optimizing PCa management.

Main Methods:

• Narrative review synthesizing key evidence on precision medicine in PCa.
• Analysis of diagnostic pathways, imaging, biomarkers, and molecular profiling.
• Framework development based on decision nodes and test-to-action rules.

Main Results:

• Risk stratification tools (polygenic scores, prediction models) can improve detection of significant PCa.
• MRI-first pathways and biomarker testing reduce unnecessary biopsies.
• PSMA PET imaging enhances staging and recurrence detection.
• Molecular profiling and longitudinal monitoring (liquid biopsy, AI pathology) are evolving tools.

Conclusions:

• A continuum of care approach integrating risk assessment, advanced diagnostics, and molecular profiling is crucial for precision PCa management.
• A decision-node-based framework can maximize clinical benefit, ensure quality, and promote equitable access to precision PCa strategies.