Pharmacogenomics and Precision Therapy in Prostate Cancer: Challenges and Perspectives

Advancements in genotyping and sequencing technologies have driven the rapid progress in human genetics research over the last 20 years. Particularly noteworthy is the emergence of pharmacogenetic and pharmacogenomic studies, which significantly impact the advancement of precision medicine and the development of genomics-guided pharmacotherapies. Acquiring knowledge about cancer genomics holds considerable importance in understanding the biology of prostate cancer. Although progress has been made in diagnosing and treating prostate cancer, metastatic castration-resistant prostate cancer (mCRPC) remains a persistent challenge due to its poor prognosis. It is important to identify predictive biomarkers, thus enabling a personalized therapeutic approach in mCRPC patients. Therefore, biomarker-driven precision oncology allows the classification of clinically significant subtypes, the identification of prognostic and predictive biomarkers, and the development and implementation of new targeted therapies. In recent years, there has been a significant shift in the management of mCRPC, whereas novel therapeutic approaches have emerged, including PARP inhibitors, immunotherapies, theranostics, notably 177Lu-PSMA-617, and others.