Dr. Kohli on the Challenges of Molecular Classification in Prostate Cancer

Manish Kohli, MD, vice chair, Department of Genitourinary Oncology, Moffitt Cancer Center, discusses the challenges of molecular classification in prostate cancer.

Predictive pathways in prostate cancer are generally understood. However, applying targeted treatment to individual patients poses an obstacle due to the heterogeneity of the disease, says Kohli. Kohli adds that treatment options pose an added risk of clonal evolution in prostate cancer.

Molecular classification is especially challenging in the metastatic hormone-sensitive setting because patients’ metastatic lesions are not profiled with a biopsy, Kohli says.

In order to overcome these challenges, Kohli’s advice is to look at liquid biopsies of patients in different states of progression, before and after treatment, and within the context of treatment-specific molecular subtypes. From there, personalized treatment may take on a greater role in the field, he concludes.