Molecular diagnostics and therapy of prostate cancer: new avenues

Co-operation and communication between clinicians and scientists is required to meet the major challenges presented by the diagnosis and therapy of prostate cancer. Molecular oncology is playing an increasing role in this field and has already been instrumental in elucidating many of the basic mechanisms underlying the development and progression of prostate cancer. By understanding these mechanisms, factors which determine whether the tumour will metastasise, such as loss of function of E-cadherin, have been identified and may help the clinician determine which therapeutic strategy is most appropriate for an individual patient. Clinicians also need more sensitive tools to help them diagnose prostate cancer and monitor its progression. The marker DD3/PCA3 shows potential in this respect. Perhaps the most fruitful area for molecular research is in the definition of new therapeutic targets useful in hormone-refractory prostate cancer. In the early stages of development are those agents which target the activation of programmed cell death, inhibition of signal transduction, inactivation of telomerase activity, and differentiation therapy. In order to accelerate the implementation of diagnostic aids and more effective therapeutic strategies for prostate cancer, clinicians must have a greater insight into the molecular mechanisms operating in their patients' disease and scientists need to understand the clinical problems involved.