[Molecular Diagnostics and Personalized Therapy for Metastatic Castration-Resistant Prostate Cancer (mCRPC)]

Metastatic castration-resistant prostate cancer (mCRPC) is a biologically heterogeneous tumor disease. Alterations in homologous recombination repair (HRR) genes, defects in the mismatch repair (MMR) system, alterations in the classical tumor suppressor genes TP53, RB1, and PTEN, and androgen receptor-mediated resistance mechanisms, promote aggressive disease courses and may influence treatment response. Molecular diagnostic approaches are gaining relevance and enable an increasingly individualized tumor characterization. Based on these insights, targeted treatment options are increasingly becoming available or are being investigated. Innovative therapeutic concepts such as T-cell engagers, chimeric antigen receptor (CAR) T-cell therapy, and androgen receptor (AR) degraders are currently under preclinical or early clinical investigation. This overview summarizes the current state of molecular diagnostics and personalized therapy in mCRPC and discusses why patient-specific, tumor-informed therapeutic approaches are becoming increasingly important in the management of mCRPC.