Table 11 Promises and limitations of therapeutic targets for PCa
From: Targeting signaling pathways in prostate cancer: mechanisms and clinical trials
Target | Promises | Limitations |
|---|---|---|
AR signaling | • Backbone of systemic therapy • Multiple lines of treatment options available • Survival benefits | • Inevitability of castration resistance • Sexual dysfunction • Other complications such as increase fat mass |
Bone microenvironment | • Prevention of skeletal-related events | • No survival benefits • Dental complications • Risk of hypocalcemia |
PSMA | • High specificity • Diagnostic and therapeutic options available | • Issues of accessibility • PSMA PET might lead to inappropriate changes in PCa management or trial participation |
DNA repair | • Promising response for selected patients | • Low incidence of DNA repair gene alterations in PCa • Unsubstantiated benefit for DNA repair gene alterations other than BRCA1/2 and ATM • Lack of evidence for OS benefit |
Immune checkpoints | • Possibility for long-term cancer remission | • Generally poor response due to immunologically ‘cold’ tumor microenvironment • Eligible for very few PCa patients |
Cell cycle | • Opportunity for synergistic success | • Limited clinical trials • Questionable safety profile |
PI3K/AKT/mTOR signaling | • Opportunity for synergistic success | • Limited clinical trials • Biomarkers needed for patient selection |
Epigenetic marks | • Mechanistically novel and promising | • Questionable safety profile • Limited efficacy |
WNT signaling | • Mechanistically promising for late stage or refractory PCa | • Bone-related toxicity • Limited clinical trials |
