Establishment of precision medicine in pharmacotherapy for castration-resistant prostate cancer

Recently, several novel agents including abiraterone, enzalutamide, docetaxel, cabazitaxel and radium-223 have become available for the treatment of castration-resistant prostate cancer (CRPC) and as a result, prognosis has improved. However, the criteria for selection of a suitable therapy have not been established. Much research on the genome has been carried out to enable precision medicine to be applied in cases of CRPC. Among them, germline polymorphisms in genes involved in androgen metabolism, such as HSD3B1, have been supposed to be the critical determinants of therapeutic outcomes in hormone therapy. Moreover, somatic aberrations such as androgen receptor, DNA-repair genes and tumorsuppressor genes (PTEN, TP53 and RBI) are also expected to act as biomarkers for therapeutic selection in CRPC. We herein report the significance of genetic polymorphism and somatic gene aberration in pharmacotherapy for prostate cancer, and we also present the current status and future perspectives with regard to the development of novel therapeutics based on genome information.