Advancements and future directions in transforming therapies of prostate cancer

ABSTRACT: The treatment landscape for advanced prostate cancer (PCa) has significantly evolved in recent years, marked by the introduction of several novel therapies. Targeting the androgen receptor (AR) remains a cornerstone of treatment, with drugs, such as abiraterone and next-generation antiandrogens, providing substantial benefits. Poly (ADP-ribose) polymerase (PARP) inhibitors, both as monotherapies and in combination with other agents, have demonstrated promise, particularly for patients with deoxyribonucleic acid (DNA) repair defects. While immunotherapy has historically shown limited efficacy in the treatment of PCa, recent findings from the CONTACT‑02 study suggest a potential breakthrough, demonstrating improved patient outcomes with the combined use of atezolizumab and cabozantinib. Additionally, emerging therapies targeting cyclin-dependent kinases 4 and 6 (CDK4/6), the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway, and epigenetic modifications offer new treatment possibilities. These advancements, coupled with ongoing research into combination therapies and novel drug targets, hold the potential to further enhance outcomes for patients with advanced PCa. This article review summarizes the latest transformative therapies in PCa care.