基于基因组学的前列腺癌临床精准诊疗研究进展

The research progress of precision medicine for prostate cancer based on genomics

前列腺癌是男性最常见的癌症类型,高居美国男性癌症死亡原因第二位。癌症基因组高通量测序的兴起使得前列腺癌的分子分型成为了可能。将基础研究成果转化为临床上有实际应用价值的生物学标志物是目前前列腺癌精准诊治的关键。因此,本文就近年来基于基因组学的前列腺癌分子分型及临床精准诊治研究进展作一综述,以切实提高前列腺癌诊治水平。

Prostate cancer is the most common type of cancer in men and the second leading cause of cancer death in men in the United States.The recent surge of high-throughput sequencing of cancer genomes has supported an expanding molecular classification of prostate cancer.Translation of these basic science studies into clinically valuable biomarkers for diagnosis and prognosis,and biomarkers which would be predictive for therapy is critical to the development of precision medicine in prostate cancer.We review potential applications aimed at improving screening specificity in prostate cancer and differentiating aggressive versus indolent prostate cancers.Furthermore,we review predictive biomarker candidates involving Ets gene rearrangements,PTEN inactivation,and androgen receptor signaling.These biomarkers and other putative biomarkers may signify aberrant oncogene pathway activation and provide a rationale for matching patients with molecularly targeted therapies in clinical trials.Finally,we advocate innovations for clinical trial design to incorporate tumor biopsy and molecular characterization to develop biomarkers and understand mechanisms of resistance.