The therapeutic landscape of prostate cancer has been transformed over the last decade by new therapeutics, advanced functional imaging, next-generation sequencing, and better use of existing therapies in early-stage disease. Until 2004, progression on androgen deprivation therapy for metastatic disease was treated with the addition of secondary hormonal manipulation; in the last decade, six systemic agents have been approved for the treatment of castration-resistant prostate cancer. We review clinical trials and survival benefit for these therapies and assess how the understanding of the disease shifted as these therapies were developed. We also discuss advances in noncastrate disease states, identification of biomarkers for prognosis and treatment selection, and opportunities in locoregional therapy to delay androgen deprivation therapy.

中文翻译：

---

晚期前列腺癌的治疗。

在过去的十年中，通过新的疗法，先进的功能成像，下一代测序以及在早期疾病中更好地利用现有疗法，前列腺癌的治疗方式已经发生了变化。直到2004年，转移激素的雄激素剥夺治疗的进展都通过增加激素的二次治疗得以解决。在过去的十年中，已经批准了六种全身性药物用于治疗去势抵抗性前列腺癌。我们回顾了这些疗法的临床试验和生存获益，并评估了随着这些疗法的发展，人们对该疾病的理解也发生了变化。我们还将讨论非cast割疾病状态的进展，预后和治疗选择的生物标志物的鉴定以及局部区域治疗中延迟雄激素剥夺治疗的机会。