Prostate cancer (PCa) is one of the most commonly diagnosed malignancies and among the leading causes of cancer-related death worldwide. It is a highly heterogeneous disease, ranging from remarkably slow progression or inertia to highly aggressive and fatal disease. As therapeutic decision-making, clinical trial design and outcome highly depend on the appropriate stratification of patients to risk groups, it is imperative to differentiate between benign versus more aggressive states. The incorporation of clinically valuable prognostic and predictive biomarkers is also potentially amenable in this process, in the timely prevention of metastatic disease and in the decision for therapy selection. This review summarizes the progress that has so far been made in the identification of the genomic events that can be used for the classification, prediction and prognostication of PCa, and as major targets for clinical intervention. We include an extensive list of emerging biomarkers for which there is enough preclinical evidence to suggest that they may constitute crucial targets for achieving significant advances in the management of the disease. Finally, we highlight the main challenges that are associated with the identification of clinically significant PCa biomarkers and recommend possible ways to overcome such limitations.

前列腺癌 (PCa) 是最常见的恶性肿瘤之一，也是全球癌症相关死亡的主要原因之一。它是一种高度异质的疾病，从非常缓慢的进展或惰性到高度侵袭性和致命的疾病。由于治疗决策、临床试验设计和结果高度依赖于患者对风险组的适当分层，因此必须区分良性与更具侵袭性的状态。临床上有价值的预后和预测性生物标志物的结合也可能适用于该过程，及时预防转移性疾病和决定治疗选择。本综述总结了迄今为止在识别可用于分类的基因组事件方面取得的进展，PCa的预测和预后，并作为临床干预的主要目标。我们列出了大量新兴生物标志物，这些生物标志物有足够的临床前证据表明它们可能构成在疾病管理方面取得重大进展的关键目标。最后，我们强调了与识别具有临床意义的 PCa 生物标志物相关的主要挑战，并推荐了克服这些限制的可能方法。