Current State of Personalized Genitourinary Cancer Radiotherapy in the Era of Precision Medicine

Abstract

Radiation therapy plays a crucial role for the management of genitourinary malignancies, with technological advancements that have led to improvements in outcomes and decrease in treatment toxicities. However, better risk-stratification and identification of patients for appropriate treatments is necessary. Recent advancements in imaging and novel genomic techniques can provide additional individualized tumor and patient information to further inform and guide treatment decisions for genitourinary cancer patients. In addition, the development and use of targeted molecular therapies based on tumor biology can result in individualized treatment recommendations. In this review, we discuss the advances in precision oncology techniques along with current applications for personalized genitourinary cancer management. We also highlight the opportunities and challenges when applying precision medicine principles to the field of radiation oncology. The identification, development and validation of biomarkers has the potential to personalize radiation therapy for genitourinary malignancies so that we may improve treatment outcomes, decrease radiation-specific toxicities, and lead to better long-term quality of life for GU cancer survivors.

Incorporating PSMA-Targeting Theranostics Into Personalized Prostate Cancer Treatment: a Multidisciplinary Perspective

“…The role of surgery and radiation therapy is evolving in the management of low-burden metastatic disease, also known as oligometastatic disease. Early data suggest that aggressive radiation targeted at metastatic lesions may improve outcomes ( 55 – 57 ). PSMA imaging may contribute to increased detection of metastatic disease and thus increased number of patients classified as oligometastatic prostate cancer.…”

“…The role of surgery and radiation therapy is evolving in the management of low-burden metastatic disease, also known as oligometastatic disease. Early data suggest that aggressive radiation targeted at metastatic lesions may improve outcomes (55)(56)(57). (59).…”

Mechanism Study on Radiosensitization Effect of Curcumin in Bladder Cancer Cells Regulated by Filamin A

“…Of note, radiotherapy is significant for bladder cancer and in palliative treatment, and proper radiotherapy could improve patient prognosis with tolerable adverse reactions. 2 Radiation therapy generally requires dose increase for radio-resistant tumors, which is always accompanied by increased damage to surrounding normal cells. In this context, radiosensitizers can compensate for the deficiency as they can reduce damage to normal cells while killing more tumor cells under the same radiation dose.…”

Noncoding-RNA-Based Therapeutics with an Emphasis on Prostatic Carcinoma—Progress and Challenges

“…Unfortunately, after castration resistance develops, the median specific survival time is ~1 year after the onset of metastasis [10]. Multiple therapeutic modalities are available for advanced PC, which have been comprehensively reviewed recently [11,12] and include hormone therapy, chemotherapy, immunotherapy, radiation and salvage prostatectomy, or various combinations of the aforementioned strategies. Despite significant therapeutic progress, metastatic PC remains incurable, and therefore, new treatments, including ncRNA therapeutics (which may be used alone or in combination with current options) are necessary.…”