Two Decades of Disease Evolution and Biomarker-Guided Clinical Decision Making in Metastatic Prostate Cancer Journal Article

   


Authors: Erazo, T.; Moiso, E.; Aras, O.; Scher, H. I.
Article Title: Two Decades of Disease Evolution and Biomarker-Guided Clinical Decision Making in Metastatic Prostate Cancer
Abstract: Despite significant advances in prostate cancer treatment over the past two decades, metastatic castration-resistant prostate cancer (mCRPC) remains incurable. We present the case of a patient with aggressive prostate cancer diagnosed 20 years ago, underscoring the value of longitudinal genomic profiling and advanced imaging to guide clinical decisions. After multiple treatment failures, genomic analyses of tissue and liquid biopsies revealed dynamic changes in tumor biology and the emergence of resistance mechanisms, particularly AR amplification, identified with a liquid biopsy test and validated by [18F]-FDHT PET scan. This finding guided treatment with bipolar androgen therapy (BAT), which achieved a dramatic clinical response, reduced AR expression, improved symptoms, and restored sensitivity to enzalutamide. This case exemplifies the utility of serial liquid biopsies in uncovering mechanisms of tumor evolution and resistance, and the crucial role of cutting-edge diagnostics in personalized cancer treatment. © 2025 Elsevier B.V., All rights reserved.
Keywords: clinical article; human tissue; treatment response; aged; cancer surgery; treatment failure; unclassified drug; genetics; prednisone; disease course; neutropenia; case report; postoperative period; drug withdrawal; cancer patient; cancer radiotherapy; cancer staging; nuclear magnetic resonance imaging; positron emission tomography; follow up; lymph node metastasis; cancer diagnosis; biological marker; prostate specific antigen; metabolism; metastasis; radiotherapy dosage; protein; cancer screening; drug resistance; pathology; drug resistance, neoplasm; tumor marker; gleason score; prostatic neoplasms; leuprorelin; myelodysplastic syndrome; bone marrow biopsy; prostate tumor; neoplasm metastasis; radiopharmaceutical agent; radical prostatectomy; dna damage response; androgen receptor; clinical decision making; prostate adenocarcinoma; inguinal lymph node; radioisotope; abiraterone acetate; receptors, androgen; drug therapy; androgen deprivation therapy; degarelix; biochemical recurrence; b raf kinase; cytopenia; fluorodeoxyglucose; nitriles; nitrile; bone scintiscanning; olaparib; castration resistant prostate cancer; phenylthiohydantoin; medical history; benzamide derivative; benzamides; testosterone cipionate; smad4 protein; radical retropubic prostatectomy; image guided radiotherapy; cabazitaxel; first-line treatment; trametinib; high throughput sequencing; metastatic prostate cancer; clinical decision-making; enzalutamide; humans; human; male; article; prostatic neoplasms, castration-resistant; tumor evolution; liquid biopsy; metastatic castration-resistant prostate cancer (mcrpc); biomarkers, tumor; positron emission tomography-computed tomography; theranostic nanomedicine; circulating free dna; bone marrow aspiration; third-line treatment; ar amplification; bipolar androgen therapy (bat); longitudinal genomic profiling; prostate specific antigen lu 177; protein kdm6a
Journal Title: International Journal of Molecular Sciences
Volume: 26
Issue: 15
ISSN: 14220067
Publisher: Elsevier B.V.  
Date Published: 2025-01-01
Start Page: 7593
Language: English
DOI: 10.3390/ijms26157593
PUBMED: 40806723
PROVIDER: scopus
PMCID: PMC12347661
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013171480&doi=10.3390%2Fijms26157593&partnerID=40&md5=aaf03eb40316d1ec52d2951bf5535663
Notes: Article -- Source: Scopus
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