Targeting key biological pathways

A leading premise for the treatment for advanced prostate cancer is to target the androgen receptor (AR) axis or to identify cases where a single pathway mutation is thought to drive carci-nogenesis. It is proposed that triaging the current pipeline of agents can be directed by building on prior successes. In light of recent advances in our knowledge of AR pathway signaling, further exploration of this pathway is warranted. Moreover, since molecular interrogation of distinct clones driving individual prostate cancers is now possible, treatment of these tumours with agents targeting these mutations would also be desirable. In the past the prostate cancer treatment paradigm has been to expose the patient to an established sequence of agents in a 'one size fits all' approach - which may have missed identifying a drug with major activity in a few patients. A strategy that is being increasingly more recognized is the need to characterize a patient's cancer and select the most appropriate treatment for that cancer pheno-type. It is also important to ensure that critical appraisal of pre-clinical and clinical research continues to help guide these endeavors to identify oncogene addiction pathways.

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