title: Clinical phenotypes of castration-resistant prostate cancer.
abstract: Castration-resistant prostate cancer (CRPC) is defined as prostate cancer that no longer responds to androgen deprivation therapy. At the genome level, CRPC is a heterogeneous disease that is marked by a range of genetic and epigenetic lesions. These lesions differ from patient to patient, but have common pathway-based themes. Clinically, a range of phenotypic presentations or subtypes of CRPC are observed that mirror this underlying heterogeneity as the disease progresses; each phenotype carries a different prognosis and different implications for treatment. In this review, we discuss the clinical subtypes of CRPC based on histology; the presence of metastatic disease and pattern of spread; patient-reported symptoms; and levels of biomarkers, such as serum bone turn- over biomarkers, prostate-specific antigen, circulating tumor cell enumeration, and neuroendocrine biomarkers. We then address the potential relationship between these clinical phenotypes (with their underlying molecular subtypes) and therapeutic decision- making and prognosis, as well as ongoing research strategies.
authors.affiliation: Duke Cancer Institute, Durham, North Carolina.
authors.forename: Tian
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Duke Cancer Institute, Durham, North Carolina.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Armstrong
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010641:Phenotype; D064129:Prostatic Neoplasms, Castration-Resistant / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology*
chemical_list: D000726:Androgen Antagonists