Abstract
Metastatic hormone-sensitive prostate cancer (mHSPC) is a clinically and molecularly heterogeneous disease. Recent insights into the biology underlying disease presentation, volume of disease, and response to therapies are starting to point toward biomarkers to improve selection for intensified and deintensified treatment strategies. In addition, the therapeutic landscape is rapidly changing, with new biomarker-driven studies targeting genotype (e.g., BRCA or PTEN mutant) and phenotype (e.g., prostate-specific membrane antigen status) in development for mHSPC. A better understanding of tumor heterogeneity, clonal evolution, and metastatic homing in prostate cancer will hopefully inform future strategies for local and systemic disease control, personalized monitoring strategies, and improved patient outcomes. PMCID: PMC12867139 Conflict of interest statement: Conflict of interest: HB has served as a consultant/advisory board member for Harpoon, Merck, Janssen, AstraZeneca, Pfizer, Amgen, Astellas, Sanofi Genzyme, Novartis, Bayer, and Daiichi Sankyo and has received institutional research funding from Janssen, Bristol Myers Squibb, Circle Pharma, Daiichi Sankyo, Novartis, and Abbvie. ABT has served as a consultant and/or advisory board member for AAA-Novartis, Janssen, MSD, AstraZeneca, Roche, Astellas, Bayer, and Bouchara-Recordati; has received travel accommodations and expenses from AAA-Novartis, Bayer, and Orion; and has been the recipient of a mobility fellowship from Institut Servier.