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Prostate cancer spans shifts from localized hormone-sensitive disease to metastatic castration-resistant prostate cancer, with aggressiveness shaped by invasion patterns and androgen-deprivation sensitivity. Single-cell and multi-region studies further support profound molecular and cellular variability, including treatment resistance mechanisms and clinically actionable mutations.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/our-current-understanding-of-the-heterogeneity-in-prostate-cancer-and-renal-cell-carcinoma/378648/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/our-current-understanding-of-the-heterogeneity-in-prostate-cancer-and-renal-cell-carcinoma/378648.png","ImageObject",300,407,{"name":42,"@type":43},"pixelkiddo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does heterogeneity mean in prostate cancer according to the review?","Question",{"text":63,"@type":64},"Heterogeneity refers to major differences across disease stages, tumor cell invasion patterns, and androgen-deprivation sensitivity, as well as molecular and cellular variability revealed by sequencing studies. It also reflects the multifocal, polyclonal nature of prostate tumors.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does androgen-deprivation therapy relate to treatment resistance?",{"text":68,"@type":64},"Initial responses to androgen-deprivation therapy are often strong, but they are not durable. Over time, tumor cells bypass androgen dependence via androgen-receptor-driven mechanisms or androgen-receptor–indifferent (e.g., neuroendocrine differentiation) mechanisms.",{"name":70,"@type":61,"acceptedAnswer":71},"Why is tumor stage and mutation profile important for prognosis and treatment selection?",{"text":72,"@type":64},"Mutational profiles differ substantially between localized and metastatic disease, and many mCRPC patients carry clinically actionable mutations. The review also notes that greater genetic heterogeneity can correspond to worse outcomes, supporting personalized treatment planning.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},378648,1790498450,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":102,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},962090883892,"https://ap-avatar.wpscdn.com/avatar/e00115db34f3e0f11b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1790152879550218658","Editorial  \nOur Current Understanding of the Heterogeneity in Prostate Cancer and Renal Cell Carcinoma  \nSha Zhu †, Junru Chen † and Hao Zeng *  \nCitation: Zhu, S.; Chen, J.; Zeng, H. Our Current Understanding of the Heterogeneity in Prostate Cancer and Renal Cell Carcinoma. J. Clin. Med. 2023, 12, 1526. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/jcm12041526](10.3390/jcm12041526)  \nReceived: 21 January 2023  \nAccepted: 8 February 2023  \nPublished: 15 February 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \nDepartment of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China  \n* Correspondence: [kucaizeng@163.com](kucaizeng@163.com)  \n† These authors contributed equally to this work.  \nAbstract: Urological cancer is a collective term for cancers of the bladder, kidney, ureter, penis, prostate, and testicles. Last year, more than 444,000 people were diagnosed with urinary cancers in the United States. In this review, we talk about the complexity of prostate and kidney cancer.  \n1. Prostate Cancer  \nProstate cancer covers a rather long natural disease history. During this time, the nature of this disease undergoes drastic shifts. In most cases, patients are diagnosed with localized hormone-sensitive prostate cancer (HSPC), and some will eventually enter the lethal stage called metastatic castration-resistant prostate cancer (mCRPC) . Besides the most common TNM classification, there are two other angles to clinically evaluate the disease: one according to the invasion of tumor cells (localized, locally advanced, and metastatic), and the other based on the sensitivity of tumors cells to androgen-deprivation therapy (ADT) (HSPC, CRPC) . The combination of these two methods enables clinicians to understand the comprehensive aggressiveness and severity of a patient's tumor.  \nProstate cancer cells generally begin as hormone-sensitive, meaning their growth relies upon the presence of androgens, making ADT the cornerstone therapy. The initial responses to ADT are rather good; however, this is not long-lasting, and all patients become insensitive to the treatment sooner or later. On a cellular level, the treatment resistance denotes that these tumor cells have managed to bypass the dependence on androgens, either through androgen receptor (AR)-driven (intra-tumoral androgen synthesis or ARamplification) or AR-indifferent (neuroendocrine differentiation) mechanisms [1] .  \nCurrently, treatment for prostate cancer includes active surveillance, radical prostatectomy, radiotherapy, anti-androgen therapy, and some investigative therapies [2,3] . Especially for advanced prostate cancer, the choices for systemic treatments are vast, which target different malignant mechanisms in tumors, such as kinome deregulation, DNA damage and repair, and cell cycle abnormalities. Thus, understanding the heterogeneity within a big patient population is crucial in tailoring effective and personal treatment plans for patients.  \nIt has been well established that prostate cancer is of a multifocal nature, i.e., multiple tumor foci that occur and develop independently, suggesting a polyclonal origin. This distinctive feature intrinsically denotes the significant heterogeneity of prostate cancer. Recent years have seen the emergence of many valuable descriptive sequencing studies that revealed prostate cancer's complexity in different disease stages [4–9] .  \nThe mutational profiles differ considerably between localized and metastatic diseases. The Cancer Genome Atlas Research Network sequenced 333 primary prostate carcinomasand demonstrated that this cohort could be divided into seven subtyp","cbCaiqUYmqtmdhw9","https://ap.wps.com/l/cbCaiqUYmqtmdhw9","pdf",212053,"English","# Prostate Cancer\n## Disease evolution and clinical evaluation angles\n## Androgen sensitivity and treatment resistance\n## Current treatment options and systemic mechanisms\n## Multifocality and polyclonal origin\n## Sequencing-based molecular subtypes and mutation patterns\n## Pathological subtypes and 2016 WHO classification","[{\"question\":\"What does heterogeneity mean in prostate cancer according to the review?\",\"answer\":\"Heterogeneity refers to major differences across disease stages, tumor cell invasion patterns, and androgen-deprivation sensitivity, as well as molecular and cellular variability revealed by sequencing studies. It also reflects the multifocal, polyclonal nature of prostate tumors.\"},{\"question\":\"How does androgen-deprivation therapy relate to treatment resistance?\",\"answer\":\"Initial responses to androgen-deprivation therapy are often strong, but they are not durable. Over time, tumor cells bypass androgen dependence via androgen-receptor-driven mechanisms or androgen-receptor–indifferent (e.g., neuroendocrine differentiation) mechanisms.\"},{\"question\":\"Why is tumor stage and mutation profile important for prognosis and treatment selection?\",\"answer\":\"Mutational profiles differ substantially between localized and metastatic disease, and many mCRPC patients carry clinically actionable mutations. The review also notes that greater genetic heterogeneity can correspond to worse outcomes, supporting personalized treatment planning.\"}]","Our Current Understanding of the Heterogeneity in Prostate Cancer and Renal Cell Carcinoma | PDF",1790231742,15]