Targeted Approaches in Metastatic Castration-Resistant Prostate Cancer: Which Data?

SIMPLE SUMMARY: Castration-resistant prostate cancer (CRPC) remains an incurable disease, but some promising innovative treatment options are under investigation. Recent developments in precision medicine have enabled the identification of new predictive biomarkers and potential targeted agents. The purpose of this review is to summarize and discuss new therapeutic approaches for metastatic CRPC (mCRPC), focusing on pathway description, prognostic and/or predictive role of recently discovered molecular alterations, investigation techniques, and potential clinical implications. ABSTRACT: Prostate cancer is the second most common diagnosed cancer and the fifth leading cause of cancer-related deaths in men worldwide. Despite significant advances in the management of castration-sensitive prostate cancer, the majority of patients develop a castration-resistant disease after a median duration of treatment of 18–48 months. The transition to a castrate resistance state could rely on alternative survival pathways, some related to androgen-independent mechanisms. Although several agents have been approved in this setting, metastatic castration-resistant prostate cancer (mCRPC) remains a lethal disease. Recent studies revealed some of the complex pathways underlying inherited and acquired mechanisms of resistance to available treatments. A better understanding of these pathways may lead to significant improvements in survival by providing innovative therapeutic targets. The present comprehensive review attempts to provide an overview of recent progress in novel targeted therapies and near-future directions.