title: Precision medicine for advanced prostate cancer.
abstract: OBJECTIVE
  Precision cancer medicine, the use of genomic profiling of patient tumors at the point-of-care to inform treatment decisions, is rapidly changing treatment strategies across cancer types. Precision medicine for advanced prostate cancer may identify new treatment strategies and change clinical practice. In this review, we discuss the potential and challenges of precision medicine in advanced prostate cancer.
  
  
  RESULTS
  Although primary prostate cancers do not harbor highly recurrent targetable genomic alterations, recent reports on the genomics of metastatic castration-resistant prostate cancer has shown multiple targetable alterations in castration-resistant prostate cancer metastatic biopsies. Therapeutic implications include targeting prevalent DNA repair pathway alterations with PARP-1 inhibition in genomically defined subsets of patients, among other genomically stratified targets. In addition, multiple recent efforts have demonstrated the promise of liquid tumor profiling (e.g., profiling circulating tumor cells or cell-free tumor DNA) and highlighted the necessary steps to scale these approaches in prostate cancer.
  
  
  CONCLUSIONS
  Although still in the initial phase of precision medicine for prostate cancer, there is extraordinary potential for clinical impact. Efforts to overcome current scientific and clinical barriers will enable widespread use of precision medicine approaches for advanced prostate cancer patients.
authors.affiliation: aDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston bCancer Program, Broad Institute of MIT and Harvard, Cambridge cCenter for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Mullane
authors.forename: Eliezer M
authors.initials: EM
authors.lastname: Van Allen
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001706:Biopsy; D020869:Gene Expression Profiling / Q000191:economics; D023281:Genomics; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007167:Immunotherapy; D008297:Male; D058990:Molecular Targeted Therapy; D009154:Mutation; D057285:Precision Medicine / Q000379:methods*; D011467:Prostate / Q000378:metabolism* / Q000473:pathology; D064129:Prostatic Neoplasms, Castration-Resistant / Q000235:genetics / Q000378:metabolism / Q000628:therapy*; D011944:Receptors, Androgen / Q000378:metabolism*; D015398:Signal Transduction / Q000187:drug effects*
chemical_list: C410798:AR protein, human; D000970:Antineoplastic Agents; D011944:Receptors, Androgen