Precision targeting in prostate cancer: Mechanistic drivers and the evolving clinical pipeline.

Abstract

Prostate cancer (PC) is one of the most common cancers among males worldwide, and its curative treatment is challenging. This review discusses pathways-including androgen receptor signalling, prostate-specific membrane antigen, DNA damage repair, neuroendocrine differentiation targets, metabolic reprogramming, Wnt/β-catenin, epigenetic modifications and stress response-and their roles in the development and progression of PC. Additionally, it outlines the medicinal agents developed and clinically evaluated against PC-whether in clinical practice or in trials-their mechanisms, therapeutic outcomes and current clinical status. Unlike the previously reported literature, this review provides integrated mechanistic insights with translational progress and offers a framework to support rational drug design and the development of next-generation therapies for better PC management.