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Prostate cancer

Prostate cancer is the home of theranostics: PSMA PET finds it, PSMA radioligands treat it. Hormonal therapy remains the foundation, with PARP and AKT inhibitors added by genotype.

Prostate cancer is the most common cancer in men in most high-income countries and the second leading cause of male cancer death. It is a spectrum: most PSA-detected disease is indolent and safely watched (ProtecT: ~3% prostate-cancer mortality at 15 years whatever the strategy), while de novo metastatic disease remains lethal within a median of about five years despite modern therapy. Diagnosis now runs PSA → multiparametric MRI (PRECISION) → targeted biopsy → Grade Group, with germline and somatic HRR testing for advanced disease and PSMA PET for staging (proPSMA) and recurrence. Digital-pathology AI (ArteraAI Prostate, 2025) and gene-expression classifiers (Decipher) refine who needs treatment and who benefits from adding hormone therapy.

Treatment is built on androgen deprivation, the first targeted cancer therapy (Huggins, 1941). Metastatic hormone-sensitive disease is treated with doublets (ADT + abiraterone, enzalutamide, apalutamide or darolutamide) or triplets adding docetaxel (ARASENS, PEACE-1), and since 31 July 2026 with 177Lu-PSMA-617 added to ADT + ARPI (PSMAddition, rPFS HR 0.72). PTEN-deficient disease gained capivasertib + abiraterone in 2026. In castration-resistant disease the sequence includes ARPI switch, PARP inhibitors for HRR-mutant tumours (PROfound, PROpel, TALAPRO-2 with OS benefit), docetaxel and cabazitaxel, radium-223 for bone-only disease, and 177Lu-PSMA-617 before or after chemotherapy (VISION, PSMAfore). Enzalutamide is approved even for high-risk PSA-only recurrence (EMBARK).

Prostate cancer is the proving ground for theranostics: PSMA PET selects and PSMA radioligands treat. Competing 177Lu-PSMA-I&T products (SPLASH, ECLIPSE) have improved progression but not yet survival; alpha-emitting 225Ac-PSMA agents are in phase 3 (AlphaBreak, AcTION) and produce responses after lutetium failure. T-cell engagers against STEAP1 (xaluritamig, XALute) and KLK2 (pasritamig) are the first immunotherapies with real activity in a disease that ignores checkpoint inhibitors; EZH2 inhibition (mevrometostat, MEVPRO) aims to re-sensitise to hormonal therapy. The unsolved problems are neuroendocrine transformation, AR-V7-driven resistance (the N-terminal-domain inhibitor masofaniten failed), Ac-225 supply, and the over- versus under-diagnosis tension in screening.

State of the art today

  • Theranostic pairing of PSMA PET and Pluvicto.
  • Genotype-directed doublets.
  • AI pathology guiding ADT duration.
  • Radioligand therapy across the metastatic continuum: 177Lu-PSMA-617 approved post-taxane (2022), pre-taxane (2025), and at first metastatic diagnosis with ARPI (31 July 2026).
  • Triplet therapy (ADT + ARPI + docetaxel) for high-volume de novo disease, with OS HR ~0.7 (ARASENS, PEACE-1).
  • Genotype-directed doublets: PARP inhibitor + ARPI for HRR-mutant (OS benefit in TALAPRO-2) and capivasertib + abiraterone for PTEN-deficient disease (2026).
  • Diagnostic pathway rebuilt around MRI-first biopsy and PSMA PET staging; active surveillance is default for low-risk disease.
  • AI pathology (ArteraAI Prostate) is FDA-authorised to predict who benefits from adding hormone therapy to radiation.
  • First immunotherapies with real activity: STEAP1 and KLK2 T-cell engagers in phase 3, after checkpoint inhibitors failed in unselected disease.
Who it affects
Show survival figures (1)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • ~1.5 million new cases and ~400,000 deaths per year worldwide; lifetime risk ~1 in 8 men in high-income countries; median age at diagnosis 67.

Where the cases are

Cases by country · GLOBOCAN 2022
All countries →

Site: Prostate. World: 1,467,854 new cases, 397,430 deaths.

#CountryNew casesDeaths
1United States of America230,12533,746
2China134,15647,522
3Japan104,31814,095
4Brazil102,51919,958
5Germany65,26918,015
6France (metropolitan)57,3579,264
7United Kingdom55,48513,237
8Russian Federation52,71214,635
9Italy38,1808,196
10India37,94818,386

Standard of care

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Localised

Active surveillance, prostatectomy, or radiation ± ADT (duration guided by risk/ArteraAI).

NCCN Guidelines: Prostate Cancer
Robotic & minimally invasive surgerySBRT / SABR (stereotactic radiotherapy)BrachytherapyArteraAI ProstateMRI
Metastatic hormone-sensitive

ADT + ARPI ± docetaxel; PSMA PET staging; capivasertib if PTEN-deficient.

NCCN Guidelines: Prostate Cancer
Androgen deprivation & AR pathway inhibitorsPSMA PETCapivasertib
Castration-resistant

ARPI switch, PARP inhibitor combinations (HRR+), 177Lu-PSMA-617, docetaxel/cabazitaxel, radium-223.

NCCN Guidelines: Prostate Cancer
Lutetium-177 vipivotide tetraxetanOlaparibNiraparibTalazoparibVISIONPSMAfore
Screening

Shared-decision PSA testing from 50 (45 if Black or family history/BRCA), risk-adapted intervals; MRI before biopsy; avoid biopsy if MRI negative and PSA density low.

PSA (prostate-specific antigen)Multiparametric prostate MRI (PI-RADS)PRECISIONGermline (hereditary) testing
Localised, low / favourable-intermediate risk

Active surveillance (PSA, MRI, repeat biopsy) for Grade Group 1 and many favourable GG2; genomic classifier or ArteraAI to refine.

Active surveillanceProtecTDecipher ProstateArteraAI ProstateGleason score / Grade Group
Localised, unfavourable-intermediate / high risk

Radical prostatectomy (robotic) or radiotherapy (hypofractionated IMRT, SBRT, or brachytherapy boost) with 4-6 months (intermediate) to 18-36 months (high risk) of ADT; abiraterone added for very high risk (STAMPEDE); ArteraAI predicts ADT benefit.

Robotic & minimally invasive surgeryIMRT / IGRT (modern external beam)SBRT / SABR (stereotactic radiotherapy)BrachytherapyAndrogen deprivation & AR pathway inhibitorsArteraAI ProstateSTAMPEDE
Biochemical recurrence

PSMA PET to localise; salvage radiotherapy ± ADT after prostatectomy; metastasis-directed SBRT for oligorecurrence (investigational for survival); enzalutamide ± ADT for high-risk BCR (EMBARK).

PSMA PETBiochemical recurrence (BCR)EMBARKEnzalutamideSBRT / SABR (stereotactic radiotherapy)PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer
Metastatic hormone-sensitive (mAPMN/S)

ADT (GnRH agonist/antagonist, e.g., relugolix) + ARPI (abiraterone, enzalutamide, apalutamide, or darolutamide); add docetaxel for high-volume de novo disease (ARASENS, PEACE-1); add 177Lu-PSMA-617 if PSMA-positive (PSMAddition, approved 31 Jul 2026); capivasertib + abiraterone if PTEN-deficient (2026); prostate RT for low-volume disease.

Abiraterone acetateEnzalutamideApalutamideDarolutamideRelugolixDocetaxelARASENSPEACE-1Lutetium-177 vipivotide tetraxetanPSMAdditionCapivasertibCAPItello-281
Non-metastatic CRPC

Apalutamide, enzalutamide, or darolutamide (SPARTAN, PROSPER, ARAMIS); PSMA PET usually reclassifies as metastatic.

ApalutamideEnzalutamideDarolutamidePSMA PET
Metastatic CRPC, first line

ARPI (if not used earlier); PARP inhibitor + ARPI for BRCA/HRR-mutant (olaparib-abiraterone, talazoparib-enzalutamide, niraparib-abiraterone); docetaxel; 177Lu-PSMA-617 after one ARPI before chemotherapy (PSMAfore); pembrolizumab if MSI-high.

OlaparibTalazoparibNiraparibPROpelTALAPRO-2MAGNITUDEPROfoundLutetium-177 vipivotide tetraxetanPSMAforeDocetaxelPembrolizumab
Metastatic CRPC, later lines

177Lu-PSMA-617 post-taxane (VISION); cabazitaxel (CARD); radium-223 for bone-only symptomatic disease (with bone protection); 225Ac-PSMA, xaluritamig, pasritamig, mevrometostat in trials; platinum-etoposide for neuroendocrine transformation; tarlatamab/I-DXd trials for DLL3/B7-H3.

Lutetium-177 vipivotide tetraxetanVISIONCabazitaxelRadium-223 dichlorideALSYMPCAActinium-225 PSMA agentsAlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)XaluritamigXALutePasritamigMevrometostatMEVPRO-1TarlatamabIfinatamab deruxtecan

Subtypes & biomarkers

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Subtypes
Biomarkers clinicians test

Target prevalence in this cancer

Target / alterationPrevalenceSource
Androgen receptor
AR-V7 in ~20-40% of mCRPC
>95%
Wikipedia
PSMA
~10% PSMA-negative or low
>90%
PMC
B7-H3
Castration-resistant disease
80-90%
Wikipedia
DLL3
Rare in adenocarcinoma
70-80%
Wikipedia
PARP
BRCA2 ~8-10%
20-25%
cBioPortal (TCGA)
AKT
Higher in mCRPC (~40%)
15-20%
cBioPortal (TCGA)
BRCA1 / BRCA2 (HRD)
8-12%
cBioPortal (TCGA)
EZH2
n/a
Wikipedia

How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.

History

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  1. 1941Huggins: castration controls prostate cancer
  2. 1941Huggins shows castration controls metastatic prostate cancer

    Nobel Prize 1966; the first hormonal therapy of any cancer.

    Androgen deprivation & AR pathway inhibitors
  3. 1966Gleason grading system published
    Gleason score / Grade Group
  4. 1986PSA test approved for monitoring; screening spreads in the 1990s
    PSA (prostate-specific antigen)
  5. 2004Docetaxel: first chemotherapy to extend survival (TAX 327)
    Docetaxel
  6. 2011Abiraterone approved
  7. 2011Abiraterone approved; enzalutamide follows in 2012

    Proof that castration-resistant disease is still AR-driven.

    Abiraterone acetateEnzalutamide
  8. 2013Radium-223: first alpha emitter approved
  9. 2013Radium-223: first alpha emitter approved (ALSYMPCA)
    Radium-223 dichlorideALSYMPCA
  10. 2015CHAARTED and STAMPEDE: docetaxel at first metastatic diagnosis
    CHAARTED (E3805)STAMPEDE
  11. 2016ProtecT validates active surveillance
    ProtecTActive surveillance
  12. 2017LATITUDE and STAMPEDE: abiraterone in mHSPC
    LATITUDESTAMPEDE
  13. 2018PRECISION: MRI before biopsy
    PRECISIONMultiparametric prostate MRI (PI-RADS)
  14. 2020PSMA PET approved; olaparib in HRR-mutant mCRPC
    PSMA PETOlaparib
  15. 2020PSMA PET approved; PROfound approves olaparib for HRR-mutant mCRPC
    Gallium-68 gozetotide (PSMA-11)proPSMAPROfoundOlaparib
  16. 2021VISION: 177Lu-PSMA-617 improves survival; TheraP beats cabazitaxel on response
    VISIONTheraP (ANZUP 1603)
  17. 2022Pluvicto approved
    Lutetium-177 vipivotide tetraxetanVISION
  18. 2022Pluvicto approved; ARASENS establishes triplet therapy
    Lutetium-177 vipivotide tetraxetanARASENSDarolutamide
  19. 2023PARP + ARPI combinations approved (TALAPRO-2, PROpel, MAGNITUDE); EMBARK for biochemical recurrence
    TALAPRO-2PROpelMAGNITUDEEMBARK
  20. 2024SPLASH: second PSMA radioligand improves rPFS but not OS
    SPLASH177Lu-PSMA-I&T
  21. 2025ArteraAI Prostate: first predictive AI pathology test
    ArteraAI Prostate
  22. 2025Pluvicto pre-chemotherapy (PSMAfore); ArteraAI Prostate FDA-authorised; PSMAddition positive; ECLIPSE positive; masofaniten discontinued
    PSMAforeArteraAI ProstatePSMAdditionECLIPSEMasofaniten
  23. 2026Pluvicto approved in metastatic hormone-sensitive disease (31 July); capivasertib + abiraterone approved for PTEN-deficient disease
    PSMAdditionLutetium-177 vipivotide tetraxetanCAPItello-281Capivasertib

Pipeline

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Phase 3Targeted alpha therapy
Actinium-225 PSMA agents
Phase 3ADC
Ifinatamab deruxtecan
ApprovedSmall-molecule AKT inhibitor
Capivasertib · Truqap
ApprovedBispecific T-cell engager (DLL3×CD3)
Tarlatamab · Imdelltra
Phase 3Bispecific T-cell engager (STEAP1×CD3, XmAb 2+1)
Xaluritamig
Phase 3Bispecific T-cell engager (KLK2×CD3)
Pasritamig
Phase 3Small-molecule EZH2 inhibitor
Mevrometostat
Phase 3Radioligand therapy (beta)
177Lu-PSMA-I&T
EstablishedGene-expression genomic classifier
Decipher Prostate
AlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)XALuteMEVPRO-1ECLIPSEPSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancerAlpha-emitting PSMA therapy at first metastatic diagnosisGRPR (gastrin-releasing peptide receptor)Multiparametric prostate MRI (PI-RADS)Active surveillance

Open problems

  • Overdiagnosis vs. underdiagnosis in screening.
  • Neuroendocrine transformation.
  • Ac-225 supply.
  • Screening trade-off: PSA reduces mortality by ~20% but overdiagnoses; MRI-first and risk-adapted intervals are only partly adopted.
  • Neuroendocrine / lineage-plastic transformation in ~15-20% of late mCRPC has no targeted therapy; DLL3 and B7-H3 agents are being borrowed from SCLC.
  • AR-V7 and N-terminal-domain resistance: masofaniten failed; AR degraders remain preclinical/early.
  • Radioligand sequencing and resistance: 10% PSMA-negative disease, heterogeneity, and no proven therapy after 177Lu failure outside trials; Ac-225 supply is the constraint.
  • Overall survival has been hard to show for PSMA radioligands beyond VISION (SPLASH, PSMAfore, TheraP confounded by crossover).
  • Immunotherapy: checkpoint inhibitors fail in unselected disease; engagers bring cytokine release and need outpatient models.
  • Disparities: Black men have ~70% higher incidence and double the mortality; trial enrolment does not reflect this.
  • Bone health, cardiovascular risk, and cognitive effects of long-term ADT in men living a decade or more.

Trials

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Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Prostate cancer
condition: Prostate cancer
Open on ClinicalTrials.gov →

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Landmark trials in OnCo

Add-AspirinAlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)ALSYMPCAARASENSARCHESCAPItello-281CHAARTED (E3805)ECLIPSEEMBARKLATITUDEMAGNITUDEMEVPRO-1PEACE-1PRECISIONPROfoundPROpelproPSMAProtecTPSMAdditionPSMAforeSPLASHSTAMPEDETALAPRO-2TheraP (ANZUP 1603)VISIONXALute

Expert centres

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Where the expertise is

Centres linked to this cancer in OnCo

Seeking a second opinion: ask your oncologist for a referral to a high-volume centre; most accept records and pathology by mail or telehealth. In the US, use the NCI's Find a Cancer Center tool or the nonprofit Cancer Commons, which navigates options for advanced cancers at no cost.

Questions to ask

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Bring to your appointment

Questions to ask your oncologist about Prostate cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 38 questions

Newly diagnosed

  1. What is my exact diagnosis, stage, and grade, and which tests established them?
    Why: Everything else follows from an accurate stage and subtype.
  2. Which biomarkers have been tested on my tumour (for example PSA, Gleason / Grade Group, PSMA PET, HRR genes, PTEN), and what were the results?
    Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
  3. Which subtype is my cancer, and does that change the recommended treatment?
    Why: Recognised subtypes for this cancer include Localised: low / favourable-intermediate / unfavourable-intermediate / high risk, Non-metastatic castration-resistant, Metastatic hormone-sensitive, de novo vs recurrent, high vs low volume.
  4. Is germline (inherited) genetic testing recommended for me or my family?
    Why: Inherited variants can change treatment and matter for relatives.

Localised

  1. For my situation (localised), which of the standard options do you recommend and why?
    Why: Guideline options include: Active surveillance, prostatectomy, or radiation ± ADT (duration guided by risk/ArteraAI).
  2. Am I a candidate for ArteraAI Prostate, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Metastatic hormone-sensitive

  1. For my situation (metastatic hormone-sensitive), which of the standard options do you recommend and why?
    Why: Guideline options include: ADT + ARPI ± docetaxel; PSMA PET staging; capivasertib if PTEN-deficient.
  2. Am I a candidate for Capivasertib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Castration-resistant

  1. For my situation (castration-resistant), which of the standard options do you recommend and why?
    Why: Guideline options include: ARPI switch, PARP inhibitor combinations (HRR+), 177Lu-PSMA-617, docetaxel/cabazitaxel, radium-223.
  2. Am I a candidate for Lutetium-177 vipivotide tetraxetan, Olaparib, Niraparib or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of VISION and PSMAfore apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Screening

  1. For my situation (screening), which of the standard options do you recommend and why?
    Why: Guideline options include: Shared-decision PSA testing from 50 (45 if Black or family history/BRCA), risk-adapted intervals; MRI before biopsy; avoid biopsy if MRI negative and PSA density low.
  2. How do the results of PRECISION apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Localised, low / favourable-intermediate risk

  1. For my situation (localised, low / favourable-intermediate risk), which of the standard options do you recommend and why?
    Why: Guideline options include: Active surveillance (PSA, MRI, repeat biopsy) for Grade Group 1 and many favourable GG2; genomic classifier or ArteraAI to refine.
  2. Am I a candidate for Decipher Prostate, ArteraAI Prostate, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of ProtecT apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Localised, unfavourable-intermediate / high risk

  1. For my situation (localised, unfavourable-intermediate / high risk), which of the standard options do you recommend and why?
    Why: Guideline options include: Radical prostatectomy (robotic) or radiotherapy (hypofractionated IMRT, SBRT, or brachytherapy boost) with 4-6 months (intermediate) to 18-36 months (high risk) of ADT; abiraterone added for very high risk (STAMPEDE); ArteraAI predicts ADT benefit.
  2. Am I a candidate for ArteraAI Prostate, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of STAMPEDE apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Biochemical recurrence

  1. For my situation (biochemical recurrence), which of the standard options do you recommend and why?
    Why: Guideline options include: PSMA PET to localise; salvage radiotherapy ± ADT after prostatectomy; metastasis-directed SBRT for oligorecurrence (investigational for survival); enzalutamide ± ADT for high-risk BCR (EMBARK).
  2. Am I a candidate for Enzalutamide, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of EMBARK apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Metastatic hormone-sensitive (mAPMN/S)

  1. For my situation (metastatic hormone-sensitive (mapmn/s)), which of the standard options do you recommend and why?
    Why: Guideline options include: ADT (GnRH agonist/antagonist, e.g., relugolix) + ARPI (abiraterone, enzalutamide, apalutamide, or darolutamide); add docetaxel for high-volume de novo disease (ARASENS, PEACE-1); add 177Lu-PSMA-617 if PSMA-positive (PSMAddition, approved 31 Jul 2026); capivasertib + abiraterone if PTEN-deficient (2026); prostate RT for low-volume disease.
  2. Am I a candidate for Abiraterone acetate, Enzalutamide, Apalutamide or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of ARASENS and PEACE-1 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Non-metastatic CRPC

  1. For my situation (non-metastatic crpc), which of the standard options do you recommend and why?
    Why: Guideline options include: Apalutamide, enzalutamide, or darolutamide (SPARTAN, PROSPER, ARAMIS); PSMA PET usually reclassifies as metastatic.
  2. Am I a candidate for Apalutamide, Enzalutamide, Darolutamide, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Metastatic CRPC, first line

  1. For my situation (metastatic crpc, first line), which of the standard options do you recommend and why?
    Why: Guideline options include: ARPI (if not used earlier); PARP inhibitor + ARPI for BRCA/HRR-mutant (olaparib-abiraterone, talazoparib-enzalutamide, niraparib-abiraterone); docetaxel; 177Lu-PSMA-617 after one ARPI before chemotherapy (PSMAfore); pembrolizumab if MSI-high.
  2. Am I a candidate for Olaparib, Talazoparib, Niraparib or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of PROpel and TALAPRO-2 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Metastatic CRPC, later lines

  1. For my situation (metastatic crpc, later lines), which of the standard options do you recommend and why?
    Why: Guideline options include: 177Lu-PSMA-617 post-taxane (VISION); cabazitaxel (CARD); radium-223 for bone-only symptomatic disease (with bone protection); 225Ac-PSMA, xaluritamig, pasritamig, mevrometostat in trials; platinum-etoposide for neuroendocrine transformation; tarlatamab/I-DXd trials for DLL3/B7-H3.
  2. Am I a candidate for Lutetium-177 vipivotide tetraxetan, Cabazitaxel, Radium-223 dichloride or related drugs, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of VISION and ALSYMPCA apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Any stage

  1. Are there clinical trials I could join, for example of Actinium-225 PSMA agents, Ifinatamab deruxtecan, Capivasertib, Tarlatamab?
    Why: Trials are how the next standard of care is set; asking early keeps options open.
  2. Would a second opinion at a high-volume centre change anything, and can you help arrange it?
    Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
  3. What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
    Why: Supportive care improves quality of life and helps patients complete treatment.
  4. I read that “Overdiagnosis vs. underdiagnosis in screening”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.
  5. I read that “Neuroendocrine transformation”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.

Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.

Everything relevant

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Direct links plus the targets, companies, and technologies of this cancer's products.

technologies

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Active surveillanceAndrogen deprivation & AR pathway inhibitorsAntibody-drug conjugate (ADC)Aspirin for cancer prevention and adjuvant therapyBone-modifying agents (bisphosphonates, denosumab)BrachytherapyCancer neuroscience: cutting the nerve supplyCytotoxic chemotherapyDietary supplements during cancer treatment: interactions and harmsDigital pathology & AIEndocrine therapy (SERMs, AIs, SERDs)Epigenetic drugs (HDAC, DNMT, EZH2, IDH, menin, BET)Focused ultrasound & histotripsyGermline (hereditary) testingImmune checkpoint inhibitorsIMRT / IGRT (modern external beam)Irreversible electroporation (NanoKnife)Magnetic nanoparticle hyperthermiaMediterranean and plant-forward dietary patternsMR-guided adaptive radiotherapyMRIMultiparametric prostate MRI (PI-RADS)Off-the-shelf cancer vaccinesPalliative radiotherapyPARP inhibitorsPathology & radiology foundation modelsPET (positron emission tomography)PET/CTPhotothermal (plasmonic) nanoparticle ablationPSMA PETRadioligand plus DNA-repair inhibitor combinationsRadioligand therapy (beta emitters)Red and processed meat reductionRNA sequencing & expression profilingRobotic & minimally invasive surgerySBRT / SABR (stereotactic radiotherapy)Sleep and circadian interventions in cancerSmall-molecule kinase inhibitorsSoy foods and breast cancerStructured exercise programmes after curative treatmentT-cell engagers (bispecific)Targeted alpha therapyTime-restricted eating in cancer prevention and survivorshipVitamin D and omega-3 supplementationWhole-body MRI

targets

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AKTAndrogen receptorB7-H3BRCA1 / BRCA2 (HRD)CD3CD73 / adenosine axisDLL3EZH2GRPR (gastrin-releasing peptide receptor)KLK2 (kallikrein-2)LIV-1 (SLC39A6)PARPPD-1PIK3CA / PI3K-alphaPSMASTEAP1VISTA

drugs

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Phase 3Radioligand therapy (beta)
177Lu-PSMA-I&T
ApprovedSmall-molecule CYP17A1 inhibitor
Abiraterone acetate · Zytiga (generic)
Phase 3Targeted alpha therapy
Actinium-225 PSMA agents
ApprovedSmall-molecule AR antagonist
Apalutamide · Erleada
ApprovedAI digital pathology prognostic/predictive test
ArteraAI Prostate
Not mapped hereOral first-generation non-steroidal antiandrogen
Bicalutamide · Casodex
ApprovedCytotoxic chemotherapy (taxane)
Cabazitaxel · Jevtana
ApprovedSmall-molecule AKT inhibitor
Capivasertib · Truqap
ApprovedSmall-molecule AR antagonist
Darolutamide · Nubeqa
EstablishedGene-expression genomic classifier
Decipher Prostate
Not mapped hereGnRH antagonist depot
Degarelix · Firmagon
ApprovedCytotoxic chemotherapy (taxane)
Docetaxel · Taxotere (generic)
ApprovedSmall-molecule AR antagonist
Enzalutamide · Xtandi
ApprovedPET imaging agent
Flotufolastat F-18 · Posluma
Not mapped herePET radiotracer (synthetic amino acid)
Fluciclovine F-18 · Axumin
ApprovedPET imaging agent
Gallium-68 gozetotide (PSMA-11) · Illuccix / Gozellix / Locametz
Phase 3ADC
Ifinatamab deruxtecan
Not mapped hereGnRH agonist depot
Leuprolide (leuprorelin) and GnRH agonists · Lupron / Eligard / Camcevi
ApprovedRadioligand therapy (beta)
Lutetium-177 vipivotide tetraxetan · Pluvicto
WithdrawnSmall-molecule AR N-terminal domain inhibitor
Masofaniten
Phase 3Small-molecule EZH2 inhibitor
Mevrometostat
ApprovedSmall-molecule PARP inhibitor
Niraparib · Zejula
ApprovedSmall-molecule PARP inhibitor
Olaparib · Lynparza
Phase 3Bispecific T-cell engager (KLK2×CD3)
Pasritamig
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedPET imaging agent
Piflufolastat F-18 / Pylarify TruVu · Pylarify
ApprovedTargeted alpha therapy (bone-seeking)
Radium-223 dichloride · Xofigo
ApprovedOral GnRH antagonist
Relugolix · Orgovyx
ApprovedSmall-molecule PARP inhibitor
Rucaparib · Rubraca
Not mapped hereAutologous cellular immunotherapy (antigen-presenting cell vaccine)
Sipuleucel-T · Provenge
ApprovedSmall-molecule PARP inhibitor
Talazoparib · Talzenna
ApprovedBispecific T-cell engager (DLL3×CD3)
Tarlatamab · Imdelltra
Phase 3Bispecific T-cell engager (STEAP1×CD3, XmAb 2+1)
Xaluritamig

companies

26
AbbVie (incl. ImmunoGen, Capstan)Aktis OncologyAmgenArteraAstellasAstraZenecaBayerBlue Earth Diagnostics (Bracco)Clarity PharmaceuticalsCuriumDaiichi SankyoESSA PharmaFerring PharmaceuticalsFusion Pharmaceuticals (AstraZeneca)GSKJohnson & JohnsonLantheusMerck & Co. (MSD)Monte Rosa TherapeuticsNovartisPfizer (incl. Seagen)SanofiSumitomo Pharma (Myovant)TakedaTelix PharmaceuticalsVeracyte (Decipher)

institutions

62
Aarhus University HospitalAll India Institute of Medical Sciences, New DelhiANZUP Cancer Trials GroupApollo Hospitals (Apollo Cancer Centres)Barts Cancer Institute / Barts Health NHS TrustCentre hospitalier de l'Université de Montréal (CHUM)Charlotte Maxeke Johannesburg Academic Hospital / University of the WitwatersrandChinese PLA General HospitalChulabhorn Hospital / Chulabhorn Royal AcademyCleveland Clinic Abu DhabiComprehensive Cancer Center Freiburg (CCCF)Duke Cancer InstituteErasmus MC Cancer InstituteFox Chase Cancer CenterFundación Arturo López PérezGarvan Institute of Medical Research / Kinghorn Cancer CentreGhent University Hospital / Cancer Research Institute GhentGunma University Heavy Ion Medical CenterGustave RoussyGuy's and St Thomas' NHS Foundation Trust / King's Health Partners Cancer CentreHerbert Irving Comprehensive Cancer Center, Columbia UniversityHokkaido University HospitalHospital de Clínicas de Porto AlegreHuntsman Cancer Institute, University of UtahInselspital, Bern University Hospital / University Cancer Center InselspitalInstituto Nacional de Câncer (INCA)Instituto Português de Oncologia do Porto Francisco GentilIRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer CenterKenyatta National HospitalKorle Bu Teaching HospitalLagos University Teaching HospitalMasaryk Memorial Cancer InstituteMovemberNRG OncologyOslo University Hospital – The Norwegian Radium HospitalPeter MacCallum Cancer CentrePostgraduate Institute of Medical Education and Research, ChandigarhQST Hospital (National Institutes for Quantum Science and Technology)Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityRoyal Adelaide HospitalSidney Kimmel Comprehensive Cancer Center at Jefferson HealthSkåne University Hospital / Lund University Cancer CentreStand Up To CancerSunnybrook Odette Cancer CentreThe Institute of Cancer ResearchThe Royal MarsdenTROG Cancer ResearchTUM Klinikum rechts der Isar / CCC MünchenUC Davis Comprehensive Cancer CenterUCLA Jonsson Comprehensive Cancer CenterUMC Utrecht Cancer CenterUniversitätsklinikum Hamburg-EppendorfUniversity College London Hospitals / UCL Cancer InstituteUniversity Hospital Düsseldorf / CIO DüsseldorfUniversity of Chicago Medicine Comprehensive Cancer CenterUniversity of Florida Health Cancer CenterUniversity of Michigan Rogel Cancer CenterUniversity of Wisconsin Carbone Cancer CenterUppsala University Hospital / Uppsala UniversityVelindre Cancer CentreWest German Cancer Center (WTZ), University Hospital Essen

pathways

13
Androgen receptor signallingBase excision repair, PARP & alkylation damageCancer neuroscience (nerve–tumour signalling)DNA damage response & homologous recombinationDouble-strand break repair: HR versus end joiningLineage plasticity & neuroendocrine transformationLipid synthesis, uptake & cholesterolOrgan tropism: seed and soilPI3K / AKT / mTORRNA splicingTranscriptional machinery & addictionTumour dormancyUbiquitin–proteasome system & protein homeostasis

terms

29
Active surveillance and observationAdenocarcinomaAdenocarcinomaAndrogen deprivation therapy (ADT)Androgen receptor pathway inhibitor (ARPI)AR-V7 splice variantBiochemical recurrence (BCR)Bone metastases and skeletal-related eventsBrachytherapy (internal radiotherapy)Cancer health disparities and equityCastration-resistant prostate cancer (CRPC)CryoablationDifferentiationGermline BRCA mutation (gBRCA)Gleason score / Grade GroupGleason score and Grade GroupGradeHormone therapyHypofractionation (fewer, larger radiotherapy doses)mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)Oligometastatic diseaseOrchiectomyPerineural invasion (PNI)PSA (prostate-specific antigen)PSA50 / PSA90 responseRadical prostatectomyTheranosticsTumour differentiation (well / moderately / poorly differentiated)Tumour marker

trials

26
Add-AspirinAlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)ALSYMPCAARASENSARCHESCAPItello-281CHAARTED (E3805)ECLIPSEEMBARKLATITUDEMAGNITUDEMEVPRO-1PEACE-1PRECISIONPROfoundPROpelproPSMAProtecTPSMAdditionPSMAforeSPLASHSTAMPEDETALAPRO-2TheraP (ANZUP 1603)VISIONXALute

pairings

4
AI pathology → androgen deprivation durationBeta radioligand → alpha radioligandPARP inhibitor + AR pathway inhibitor (prostate)PSMA PET → PSMA radioligand therapy

roadmaps

1
Radiopharmaceutical roadmap: iodine → lutetium → actinium

ideas

58
A multi-cancer platform trial of adaptive (dose-holiday) therapyA pragmatic trial network for intraoperative margin tools, paid on margin reductionA public fund and label pathway to trial generic drugs against cancerA regulatory endpoint for drugs that block spread, not tumoursA short pre-surgery drug window as the default early test of new agentsA standing platform trial for every major cancer, funded as infrastructureA test to tell true oligometastatic disease from hidden widespread spreadA video-based surgical quality registry linking assessed skill to cancer outcomesAlpha-emitting PSMA therapy at first metastatic diagnosisAn international body to rename indolent lesions so 'cancer' means somethingAn organotropism atlas that predicts where a cancer will spreadAutomatic germline testing for every cancer type where it changes careAutonomous closed-loop adaptive therapy driven by blood tests and evolutionary modelsCardiometabolic screening and treatment for survivors on long-term hormone therapyCertified decision aids required for every preference-sensitive cancer decisionCirculating tumour cell clearance as the phase 2 gate for anti-metastatic drugsCoverage-with-evidence registries for MR-guided and adaptive radiotherapyCut the nerve supply to tumours with old drugsDecision aids built into the record for every preference-sensitive cancer choiceDestroy the truncated androgen receptor that hormone drugs cannot touchDetect tumours changing cell type from RNA in the bloodDevice-agnostic public trials of ablation technologies against surgeryEradicate dormant cancer cells: a programme to wake and kill or lock asleep disseminated cellsEvolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trialsFix the neutrophil count rule that excludes many people of African ancestryGrow blood-borne tumour cells to test drugs on the cells that actually spreadGrow models from tumour cells in the blood when a biopsy is impossibleKeep dormant cells asleep instead of trying to kill themKeep them asleep: dormancy maintenance as adjuvant therapyMake every cold tumour hot: a coordinated programme to reprogramme immune-excluded tumoursMake one-week radiotherapy the default in overloaded systemsMandatory staged registries for new surgical techniques before wide adoptionModern autopsy studies to measure how much silent cancer people carryMolecular indolence classifiers bundled with every screening programmeMRI-first prostate screening with genetic pre-selectionPatent-free open-source development of repurposed and off-patent cancer drugsPay for supervised exercise the way we pay for drugsPay per course of radiotherapy, not per session, so short courses are not penalisedPayer-funded trials that omit surgery or radiotherapy in low-risk patientsPooled coverage-with-evidence for proton therapy across all centresPre-consented cohorts that can be randomised to future trials (TwiCs)Prostate active surveillance without scheduled biopsies: MRI and blood tests decidePSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancerQualify PSMA PET tumour volume as a validated imaging biomarkerReal-time margin assessment and image-guided surgery as the global standardRisk-stratified follow-up: low-risk survivors to primary care with fast re-entryRotate between drugs on a fixed schedule instead of waiting for failureSexual health assessed and treated as a standard toxicity domainSMART designs to test treatment strategies, not just single drugsStructured exercise prescribed like a drug in all curative-intent cancer careTest whether calling Gleason 6 'not cancer' changes what men chooseTotal-body PET for personalised radioligand dosingUse a hypoxia scan to pick patients for adenosine-pathway drugsUse a polygenic risk score to set when screening startsUse food effects to cut the dose and cost of oral drugs that absorb better with mealsWhat decides which disseminated cells ever colonise?When the blood test is positive, hunt for the lesion with sensitive imagingWhich patients' blood clones will become leukaemia after treatment?

collections

1
Prostate Cancer Foundation (PCF)

people

30
Amar U. KishanArul M. ChinnaiyanCharles L. SawyersClemens KratochwilDeborah Watkins BrunerDingwei YeEliezer M. Van AllenEric J. SmallHoward I. ScherJae Lyun LeeJames L. GulleyJeremie CalaisJohann de BonoJohannes CzerninKarim FizaziMarkus GraefenMichael HofmanMichael J. MorrisNeeraj AgarwalNicholas JamesOwen N. WittePadmanee SharmaPeter BartensteinPrimo N. Lara Jr.Rahul AggarwalRamon E. ParsonsRobert A. GatenbyShahneen SandhuThomas A. HopeWilliam G. Nelson

bottlenecks

15
Acquired resistance to every therapyAI that is built but not validated or deployedCold tumours and the immunosuppressive microenvironmentInherited risk is mostly unidentifiedManufacturing cost and time for living and radioactive medicinesMetastasis is understood least and studied lastMisinformation and unproven therapiesNo incentive to repurpose cheap drugsOlder and multimorbid patients are excluded and undertreatedOverdiagnosis and false alarmsSurgery and radiotherapy cure most, get leastSurvivorship and late effects are neglectedToo many combinations to testTrial design, endpoints and costTrials do not represent the people who get cancer

key papers

2
STAMPEDE: adding abiraterone to hormone therapy at diagnosis of advanced prostate cancerVISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer

journals

1
European Urology

Key papers

2top
rctNew England Journal of Medicine 2021changed practice
VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer

Men with metastatic castration-resistant prostate cancer that has progressed after hormonal therapy and chemotherapy, and whose tumours show PSMA on a PET scan, can now receive lutetium-PSMA, which extends life, controls pain and is usually better tolerated than further chemotherapy. It has established a new treatment class in which a scan decides who gets the matching radioactive drug, and it is now being tested earlier in the disease (PSMAfore, PSMAddition).

rctNew England Journal of Medicine 2017changed practice
STAMPEDE: adding abiraterone to hormone therapy at diagnosis of advanced prostate cancer

Men diagnosed with prostate cancer that has already spread, or that is locally advanced and high risk, should start abiraterone (or another androgen-receptor pathway inhibitor) at the same time as testosterone suppression rather than waiting for resistance. This roughly halves the risk of death over several years. The same platform later showed that docetaxel chemotherapy and, in high-volume metastatic disease, triple therapy also help, and that abiraterone benefits men with high-risk disease treated with radiotherapy.

Latest papers

top
Literature trend7,865 papers in the last 12 months-1% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this cancer: (TITLE:"Prostate cancer" OR ABSTRACT:"Prostate cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Prostate cancer, not a curated reading list.

Connected

344top

technologies

37
Active surveillanceAndrogen deprivation & AR pathway inhibitorsAspirin for cancer prevention and adjuvant therapyBone-modifying agents (bisphosphonates, denosumab)BrachytherapyCancer neuroscience: cutting the nerve supplyCytotoxic chemotherapyDietary supplements during cancer treatment: interactions and harmsDigital pathology & AIEpigenetic drugs (HDAC, DNMT, EZH2, IDH, menin, BET)Focused ultrasound & histotripsyGermline (hereditary) testingIMRT / IGRT (modern external beam)Irreversible electroporation (NanoKnife)Magnetic nanoparticle hyperthermiaMediterranean and plant-forward dietary patternsMR-guided adaptive radiotherapyMRIMultiparametric prostate MRI (PI-RADS)Off-the-shelf cancer vaccinesPalliative radiotherapyPARP inhibitorsPhotothermal (plasmonic) nanoparticle ablationPSMA PETRadioligand plus DNA-repair inhibitor combinationsRadioligand therapy (beta emitters)Red and processed meat reductionRobotic & minimally invasive surgerySBRT / SABR (stereotactic radiotherapy)Sleep and circadian interventions in cancerSoy foods and breast cancerStructured exercise programmes after curative treatmentT-cell engagers (bispecific)Targeted alpha therapyTime-restricted eating in cancer prevention and survivorshipVitamin D and omega-3 supplementationWhole-body MRI

targets

14
AKTAndrogen receptorB7-H3BRCA1 / BRCA2 (HRD)CD73 / adenosine axisDLL3EZH2GRPR (gastrin-releasing peptide receptor)KLK2 (kallikrein-2)LIV-1 (SLC39A6)PARPPSMASTEAP1VISTA

drugs

33
Phase 3Radioligand therapy (beta)
177Lu-PSMA-I&T
ApprovedSmall-molecule CYP17A1 inhibitor
Abiraterone acetate · Zytiga (generic)
Phase 3Targeted alpha therapy
Actinium-225 PSMA agents
ApprovedSmall-molecule AR antagonist
Apalutamide · Erleada
ApprovedAI digital pathology prognostic/predictive test
ArteraAI Prostate
Not mapped hereOral first-generation non-steroidal antiandrogen
Bicalutamide · Casodex
ApprovedCytotoxic chemotherapy (taxane)
Cabazitaxel · Jevtana
ApprovedSmall-molecule AKT inhibitor
Capivasertib · Truqap
ApprovedSmall-molecule AR antagonist
Darolutamide · Nubeqa
EstablishedGene-expression genomic classifier
Decipher Prostate
Not mapped hereGnRH antagonist depot
Degarelix · Firmagon
ApprovedCytotoxic chemotherapy (taxane)
Docetaxel · Taxotere (generic)
ApprovedSmall-molecule AR antagonist
Enzalutamide · Xtandi
ApprovedPET imaging agent
Flotufolastat F-18 · Posluma
Not mapped herePET radiotracer (synthetic amino acid)
Fluciclovine F-18 · Axumin
ApprovedPET imaging agent
Gallium-68 gozetotide (PSMA-11) · Illuccix / Gozellix / Locametz
Phase 3ADC
Ifinatamab deruxtecan
Not mapped hereGnRH agonist depot
Leuprolide (leuprorelin) and GnRH agonists · Lupron / Eligard / Camcevi
ApprovedRadioligand therapy (beta)
Lutetium-177 vipivotide tetraxetan · Pluvicto
WithdrawnSmall-molecule AR N-terminal domain inhibitor
Masofaniten
Phase 3Small-molecule EZH2 inhibitor
Mevrometostat
ApprovedSmall-molecule PARP inhibitor
Niraparib · Zejula
ApprovedSmall-molecule PARP inhibitor
Olaparib · Lynparza
Phase 3Bispecific T-cell engager (KLK2×CD3)
Pasritamig
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedPET imaging agent
Piflufolastat F-18 / Pylarify TruVu · Pylarify
ApprovedTargeted alpha therapy (bone-seeking)
Radium-223 dichloride · Xofigo
ApprovedOral GnRH antagonist
Relugolix · Orgovyx
ApprovedSmall-molecule PARP inhibitor
Rucaparib · Rubraca
Not mapped hereAutologous cellular immunotherapy (antigen-presenting cell vaccine)
Sipuleucel-T · Provenge
ApprovedSmall-molecule PARP inhibitor
Talazoparib · Talzenna
ApprovedBispecific T-cell engager (DLL3×CD3)
Tarlatamab · Imdelltra
Phase 3Bispecific T-cell engager (STEAP1×CD3, XmAb 2+1)
Xaluritamig

companies

18
Aktis OncologyAmgenArteraAstellasAstraZenecaBayerBlue Earth Diagnostics (Bracco)Clarity PharmaceuticalsCuriumESSA PharmaJohnson & JohnsonLantheusMonte Rosa TherapeuticsNovartisPfizer (incl. Seagen)Sumitomo Pharma (Myovant)Telix PharmaceuticalsVeracyte (Decipher)

institutions

62
Aarhus University HospitalAll India Institute of Medical Sciences, New DelhiANZUP Cancer Trials GroupApollo Hospitals (Apollo Cancer Centres)Barts Cancer Institute / Barts Health NHS TrustCentre hospitalier de l'Université de Montréal (CHUM)Charlotte Maxeke Johannesburg Academic Hospital / University of the WitwatersrandChinese PLA General HospitalChulabhorn Hospital / Chulabhorn Royal AcademyCleveland Clinic Abu DhabiComprehensive Cancer Center Freiburg (CCCF)Duke Cancer InstituteErasmus MC Cancer InstituteFox Chase Cancer CenterFundación Arturo López PérezGarvan Institute of Medical Research / Kinghorn Cancer CentreGhent University Hospital / Cancer Research Institute GhentGunma University Heavy Ion Medical CenterGustave RoussyGuy's and St Thomas' NHS Foundation Trust / King's Health Partners Cancer CentreHerbert Irving Comprehensive Cancer Center, Columbia UniversityHokkaido University HospitalHospital de Clínicas de Porto AlegreHuntsman Cancer Institute, University of UtahInselspital, Bern University Hospital / University Cancer Center InselspitalInstituto Nacional de Câncer (INCA)Instituto Português de Oncologia do Porto Francisco GentilIRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer CenterKenyatta National HospitalKorle Bu Teaching HospitalLagos University Teaching HospitalMasaryk Memorial Cancer InstituteMovemberNRG OncologyOslo University Hospital – The Norwegian Radium HospitalPeter MacCallum Cancer CentrePostgraduate Institute of Medical Education and Research, ChandigarhQST Hospital (National Institutes for Quantum Science and Technology)Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityRoyal Adelaide HospitalSidney Kimmel Comprehensive Cancer Center at Jefferson HealthSkåne University Hospital / Lund University Cancer CentreStand Up To CancerSunnybrook Odette Cancer CentreThe Institute of Cancer ResearchThe Royal MarsdenTROG Cancer ResearchTUM Klinikum rechts der Isar / CCC MünchenUC Davis Comprehensive Cancer CenterUCLA Jonsson Comprehensive Cancer CenterUMC Utrecht Cancer CenterUniversitätsklinikum Hamburg-EppendorfUniversity College London Hospitals / UCL Cancer InstituteUniversity Hospital Düsseldorf / CIO DüsseldorfUniversity of Chicago Medicine Comprehensive Cancer CenterUniversity of Florida Health Cancer CenterUniversity of Michigan Rogel Cancer CenterUniversity of Wisconsin Carbone Cancer CenterUppsala University Hospital / Uppsala UniversityVelindre Cancer CentreWest German Cancer Center (WTZ), University Hospital Essen

pathways

13
Androgen receptor signallingBase excision repair, PARP & alkylation damageCancer neuroscience (nerve–tumour signalling)DNA damage response & homologous recombinationDouble-strand break repair: HR versus end joiningLineage plasticity & neuroendocrine transformationLipid synthesis, uptake & cholesterolOrgan tropism: seed and soilPI3K / AKT / mTORRNA splicingTranscriptional machinery & addictionTumour dormancyUbiquitin–proteasome system & protein homeostasis

terms

29
Active surveillance and observationAdenocarcinomaAdenocarcinomaAndrogen deprivation therapy (ADT)Androgen receptor pathway inhibitor (ARPI)AR-V7 splice variantBiochemical recurrence (BCR)Bone metastases and skeletal-related eventsBrachytherapy (internal radiotherapy)Cancer health disparities and equityCastration-resistant prostate cancer (CRPC)CryoablationDifferentiationGermline BRCA mutation (gBRCA)Gleason score / Grade GroupGleason score and Grade GroupGradeHormone therapyHypofractionation (fewer, larger radiotherapy doses)mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)Oligometastatic diseaseOrchiectomyPerineural invasion (PNI)PSA (prostate-specific antigen)PSA50 / PSA90 responseRadical prostatectomyTheranosticsTumour differentiation (well / moderately / poorly differentiated)Tumour marker

trials

26
Add-AspirinAlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)ALSYMPCAARASENSARCHESCAPItello-281CHAARTED (E3805)ECLIPSEEMBARKLATITUDEMAGNITUDEMEVPRO-1PEACE-1PRECISIONPROfoundPROpelproPSMAProtecTPSMAdditionPSMAforeSPLASHSTAMPEDETALAPRO-2TheraP (ANZUP 1603)VISIONXALute

pairings

4
AI pathology → androgen deprivation durationBeta radioligand → alpha radioligandPARP inhibitor + AR pathway inhibitor (prostate)PSMA PET → PSMA radioligand therapy

roadmaps

1
Radiopharmaceutical roadmap: iodine → lutetium → actinium

ideas

58
A multi-cancer platform trial of adaptive (dose-holiday) therapyA pragmatic trial network for intraoperative margin tools, paid on margin reductionA public fund and label pathway to trial generic drugs against cancerA regulatory endpoint for drugs that block spread, not tumoursA short pre-surgery drug window as the default early test of new agentsA standing platform trial for every major cancer, funded as infrastructureA test to tell true oligometastatic disease from hidden widespread spreadA video-based surgical quality registry linking assessed skill to cancer outcomesAlpha-emitting PSMA therapy at first metastatic diagnosisAn international body to rename indolent lesions so 'cancer' means somethingAn organotropism atlas that predicts where a cancer will spreadAutomatic germline testing for every cancer type where it changes careAutonomous closed-loop adaptive therapy driven by blood tests and evolutionary modelsCardiometabolic screening and treatment for survivors on long-term hormone therapyCertified decision aids required for every preference-sensitive cancer decisionCirculating tumour cell clearance as the phase 2 gate for anti-metastatic drugsCoverage-with-evidence registries for MR-guided and adaptive radiotherapyCut the nerve supply to tumours with old drugsDecision aids built into the record for every preference-sensitive cancer choiceDestroy the truncated androgen receptor that hormone drugs cannot touchDetect tumours changing cell type from RNA in the bloodDevice-agnostic public trials of ablation technologies against surgeryEradicate dormant cancer cells: a programme to wake and kill or lock asleep disseminated cellsEvolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trialsFix the neutrophil count rule that excludes many people of African ancestryGrow blood-borne tumour cells to test drugs on the cells that actually spreadGrow models from tumour cells in the blood when a biopsy is impossibleKeep dormant cells asleep instead of trying to kill themKeep them asleep: dormancy maintenance as adjuvant therapyMake every cold tumour hot: a coordinated programme to reprogramme immune-excluded tumoursMake one-week radiotherapy the default in overloaded systemsMandatory staged registries for new surgical techniques before wide adoptionModern autopsy studies to measure how much silent cancer people carryMolecular indolence classifiers bundled with every screening programmeMRI-first prostate screening with genetic pre-selectionPatent-free open-source development of repurposed and off-patent cancer drugsPay for supervised exercise the way we pay for drugsPay per course of radiotherapy, not per session, so short courses are not penalisedPayer-funded trials that omit surgery or radiotherapy in low-risk patientsPooled coverage-with-evidence for proton therapy across all centresPre-consented cohorts that can be randomised to future trials (TwiCs)Prostate active surveillance without scheduled biopsies: MRI and blood tests decidePSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancerQualify PSMA PET tumour volume as a validated imaging biomarkerReal-time margin assessment and image-guided surgery as the global standardRisk-stratified follow-up: low-risk survivors to primary care with fast re-entryRotate between drugs on a fixed schedule instead of waiting for failureSexual health assessed and treated as a standard toxicity domainSMART designs to test treatment strategies, not just single drugsStructured exercise prescribed like a drug in all curative-intent cancer careTest whether calling Gleason 6 'not cancer' changes what men chooseTotal-body PET for personalised radioligand dosingUse a hypoxia scan to pick patients for adenosine-pathway drugsUse a polygenic risk score to set when screening startsUse food effects to cut the dose and cost of oral drugs that absorb better with mealsWhat decides which disseminated cells ever colonise?When the blood test is positive, hunt for the lesion with sensitive imagingWhich patients' blood clones will become leukaemia after treatment?

collections

1
Prostate Cancer Foundation (PCF)

people

30
Amar U. KishanArul M. ChinnaiyanCharles L. SawyersClemens KratochwilDeborah Watkins BrunerDingwei YeEliezer M. Van AllenEric J. SmallHoward I. ScherJae Lyun LeeJames L. GulleyJeremie CalaisJohann de BonoJohannes CzerninKarim FizaziMarkus GraefenMichael HofmanMichael J. MorrisNeeraj AgarwalNicholas JamesOwen N. WittePadmanee SharmaPeter BartensteinPrimo N. Lara Jr.Rahul AggarwalRamon E. ParsonsRobert A. GatenbyShahneen SandhuThomas A. HopeWilliam G. Nelson

bottlenecks

15
Acquired resistance to every therapyAI that is built but not validated or deployedCold tumours and the immunosuppressive microenvironmentInherited risk is mostly unidentifiedManufacturing cost and time for living and radioactive medicinesMetastasis is understood least and studied lastMisinformation and unproven therapiesNo incentive to repurpose cheap drugsOlder and multimorbid patients are excluded and undertreatedOverdiagnosis and false alarmsSurgery and radiotherapy cure most, get leastSurvivorship and late effects are neglectedToo many combinations to testTrial design, endpoints and costTrials do not represent the people who get cancer

key papers

2
STAMPEDE: adding abiraterone to hormone therapy at diagnosis of advanced prostate cancerVISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer

journals

1
European Urology