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Exploring the biology of metastatic hormone-sensitive prostate cancer: on the road to precision medicine
Alice Bernard-Tessier, Himisha Beltran
Alice Bernard-Tessier, Himisha Beltran
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Review

Exploring the biology of metastatic hormone-sensitive prostate cancer: on the road to precision medicine

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Abstract

Metastatic hormone-sensitive prostate cancer (mHSPC) is a clinically and molecularly heterogeneous disease. Recent insights into the biology underlying disease presentation, volume of disease, and response to therapies are starting to point toward biomarkers to improve selection for intensified and deintensified treatment strategies. In addition, the therapeutic landscape is rapidly changing, with new biomarker-driven studies targeting genotype (e.g., BRCA or PTEN mutant) and phenotype (e.g., prostate-specific membrane antigen status) in development for mHSPC. A better understanding of tumor heterogeneity, clonal evolution, and metastatic homing in prostate cancer will hopefully inform future strategies for local and systemic disease control, personalized monitoring strategies, and improved patient outcomes.

Authors

Alice Bernard-Tessier, Himisha Beltran

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Figure 2

Approaches used to capture tumor biology and their limitations.

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Approaches used to capture tumor biology and their limitations.
(A) Tiss...
(A) Tissue samples provide detailed molecular information but fail to reflect clonal evolution over time. (B) At the time of diagnosis of hormone-sensitive cancer, the ctDNA fraction is often low and does not allow the same depth of analysis as tissue samples. ADT, androgen deprivation therapy; ctDNA, circulating tumor DNA.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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