Prostate Cancer Treatment and Research
Open access
Peer reviewed
Scollr summary
What this paper is about
This narrative review reframes high-risk prostate cancer management as an effort to reprogram the evolutionary trajectory and delay castration resistance, addressing current risk stratification, androgen receptor (AR)-dependent and AR-independent mechanisms of resistance, and multidisciplinary strategies that modify selective pressure.
Full abstract
Read the full abstract
Background/Objectives: High-risk prostate cancer is a biologically heterogeneous group of tumors carrying a substantial risk of progression to lethal, castration-resistant disease. Although androgen deprivation therapy (ADT) remains the therapeutic backbone, nearly all advanced disease eventually progresses to castration-resistant prostate cancer (CRPC) through Darwinian clonal evolution under sustained therapeutic pressure. This narrative review reframes high-risk prostate cancer management as an effort to reprogram the evolutionary trajectory and delay castration resistance, addressing current risk stratification, androgen receptor (AR)-dependent and AR-independent mechanisms of resistance, and multidisciplinary strategies that modify selective pressure. Methods: A narrative review of the literature was conducted, including peer-reviewed studies, pivotal phase III trial reports, and current clinical practice guidelines indexed in PubMed, Scopus, and Web of Science up to 2026. Sources on high-risk and castration-resistant prostate cancer, the biology of treatment resistance, and multidisciplinary treatment intensification were selected and synthesized. Results: Treatment intensification has been extended to high-risk biochemical recurrence (EMBARK), directed by biomarkers in PTEN-deficient disease (CAPItello-281), and moved earlier through prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PSMAfore, PSMAddition). In localized disease, effective AR-pathway intensification with abiraterone (STAMPEDE) contrasts with the failure of chemotherapy (PEACE-2) and enzalutamide (ENZARAD). Emerging therapies targeting lineage plasticity exploit its dynamic and potentially reversible biology, raising the prospect of reversing established resistance rather than merely delaying it. CAPItello-281 and PSMAddition have immature overall survival data and are not yet standard of care. Conclusions: Coordinated multidisciplinary care, matched to the disease stage and molecular context, offers a realistic path to delay castration resistance and improve survival.
Direct answer
What can I do from this paper page?
Use this page to scan "Reprogramming the Evolution of High-Risk Prostate Cancer: Multidisciplinary Strategies to Delay Castration Resistance" quickly: start with the summary and abstract, then check the authors, source, topics, and related papers. From here, open Scollr to follow Prostate Cancer Treatment and Research, save the paper, or map adjacent work.
Research areas
Follow related topics
Citation
BibTeX
@article{Sim2026Reprogramming,
title = {Reprogramming the Evolution of High-Risk Prostate Cancer: Multidisciplinary Strategies to Delay Castration Resistance},
author = {Younghun Sim and Jae Won Choi and Dong Seob Kim and Jeong Hyun Kim and Sung Goo Yoon and Jung Ki Jo},
journal = {Journal of Clinical Medicine},
year = {2026},
doi = {10.3390/jcm15166488},
url = {https://doi.org/10.3390/jcm15166488}
}FAQ
Using this paper in a discovery workflow
How do I find related work for this paper?
Use the related papers and topic links on this page as starting points. In Scollr, you can also open the paper and build a literature map around its references, citing papers, and related work.
How can I keep up with new Prostate Cancer Treatment and Research papers?
Follow Prostate Cancer Treatment and Research in Scollr. New papers from the topic flow into a personalized feed, and you can save useful studies to revisit later.
Can I cite this paper from this page?
This page includes a static BibTeX block for Reprogramming the Evolution of High-Risk Prostate Cancer: Multidisciplinary Strategies to Delay Castration Resistance. Always verify the DOI, source, and publication details against the publisher record before submitting a manuscript.
Follow this research in Scollr
Follow the topics and authors behind this paper, save useful studies, and build a literature map when you are ready to go deeper.
Get the app