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The review explains how phenotypic precision medicine—identifying and targeting observable cancer features—can complement genomic approaches, discussing its clinical benefits, constraints, and the role of image-based phenotypic biomarkers. It also outlines how these strategies may better characterize advanced disease burden and support more individualized treatment selection.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-value-of-phenotypic-precision-medicine-in-prostate-cancer/406656/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-value-of-phenotypic-precision-medicine-in-prostate-cancer/406656.png","ImageObject",300,407,{"name":92,"@type":93},"dhado","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is precision medicine important in prostate cancer?","Question",{"text":112,"@type":113},"Precision medicine helps improve outcomes by using molecular and genomic biomarkers to guide treatment selection, though benefit is limited to a minority of patients. 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Therefore, alternative tools are considered necessary.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},406656,1791354019,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41,"preview_page_count":4},5909893218464,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","The Value of Phenotypic Precision Medicine in Prostate Cancer  \nNathan M. Hawkey,1 Amanda Broderick,1 Daniel J. George,1,2 Oliver Sartor,3  \nAndrew J. Armstrong1,2,*,  \n1Department of Medicine, Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA 2Duke Cancer Institute Center for Prostate and Urologic Cancer, Duke University, Durham, NC, USA  \n3Tulane Cancer Center, Division of Genitourinary Oncology, New Orleans, LA, USA  \n*Corresponding author: Andrew J. Armstrong, MD, ScM, FACP, Department of Medicine, Surgery, Pharmacology and Cancer Biology, Director of Research, the Duke Cancer Institute Center for Prostate and Urologic Cancers, Divisions of Medical Oncology and Urology, Duke University, DUMC Box 103861, Durham, NC 27710, USA; [Email:](Email: Andrew.armstrong@duke.edu)[ Andrew.armstrong@duke.edu](Email: Andrew.armstrong@duke.edu)  \nAbstract  \nProstate cancer is the most common cancer among men and the second leading cause of cancer-related death. For patients who develop metastatic disease, tissue-based and circulating-tumor–based molecular and genomic biomarkers have emerged as a means of improving outcomes through the application of precision medicine. However, the benefit is limited to a minority of patients. An additional approach to further characterize the biology of advanced prostate cancer is through the use of phenotypic precision medicine, or the identification and targeting of phenotypic features of an individual patient’s cancer. In this review article, we will discuss the background, potential clinical benefits, and limitations of genomic and phenotypic precision medicine in prostate cancer. We will also highlight how the emergence of image-based phenotypic medicine may lead to greater characterization of advanced prostate cancer disease burden and more individualized treatment approaches in patients. Key words: phenotypic precision medicine; image-based biomarkers; prostate-specific membrane antigen (PSMA); metastatic castrate-resistant prostate cancer; precision medicine; radiopharmaceuticals.  \nImplications for Practice  \nApproximately 20%–40% of men with perceived localized prostate cancer relapse after definitive surgery or radiation therapy with or without androgen deprivation therapy. Subsequent therapies, including those targeting the androgen-signaling axis and taxane chemotherapies, have improved survival in patients with metastatic disease. With the widespread introduction of tumor sequencing, genomic precision medicine has identified genetic alterations in patient subsets who derive additional benefit from targeted therapies. However, few patients will benefit from genomic precision medicine, and alternative approaches are essential. Image-based phenotypic precision medicine has emerged as an additional tool offering therapeutic options for a potentially greater number of patients.  \nIntroduction  \nProstate cancer (PC) is the most common cancer among US men, and metastatic PC (mPC) is the second leading cause of cancer-related death, with a 5-year survival near 30% for distant-stage disease.1,2 Early detection and local therapy have resulted in improved PC–specific survival; however, ~20%– 40% of men relapse after surgery or radiation therapy (with or without androgen deprivation therapy) .3,4 For mPC, tissueand circulating-tumor-cell (CTC)–based molecular/genomic biomarkers have emerged as means of improving outcomes through application of precision medicine.5,6  \nThis PC landscape is complicated by vast genotypic and histomorphologic heterogeneity across patients, between tumor sites within individual patients, and among different loci within single tumors.7,8 These features make prediction of an individual patient’s cancer challenging, which is essential  \nfor successful application of precision medicine targeting specific genomic features.9 Despite this, there has been success in the metastatic castration-resistant PC (mCRPC) setting with poly (ADP-ribose) polymer","cbCairhzszGSU13B","https://ap.wps.com/l/cbCairhzszGSU13B","pdf",17450993,12,"English","# Abstract\n# Implications for Practice\n# Introduction\n# Genotypic Precision Medicine in PC","[{\"question\":\"Why is precision medicine important in prostate cancer?\",\"answer\":\"Precision medicine helps improve outcomes by using molecular and genomic biomarkers to guide treatment selection, though benefit is limited to a minority of patients. Metastatic disease particularly drives the need for better characterization.\"},{\"question\":\"What is phenotypic precision medicine in this review?\",\"answer\":\"Phenotypic precision medicine focuses on identifying and targeting phenotypic features of an individual patient’s cancer. It is presented as an additional approach when genomic precision medicine benefits only few patients.\"},{\"question\":\"What limitations affect genomic precision medicine in prostate cancer?\",\"answer\":\"The review notes that genomic precision medicine benefits only a minority of patients, despite the availability of tumor sequencing and clinically validated treatments tied to genetic biomarkers. Therefore, alternative tools are considered necessary.\"}]","The Value of Phenotypic Precision Medicine in Prostate Cancer | PDF",1790567035]