Molecular classification of prostate cancer and its clinical implications

The technical development of molecular investigation techniques has enabled the comprehensive discovery of the molecular background of prostate cancer. This can lead to a more accurate prediction of the heterogeneous behaviour of this disease and provide crucial basis for the selection of the most effective individual treatment strategy. Due to the diverse molecular alterations, various classifications have been proposed, although a widespread consensus has not yet been established. In this review, we summarize the proposed classification systems developed so far, with particular emphasis on their clinical and therapeutic implications. Furthermore, we discuss molecular prognostic test methods with established clinical recommendations (Oncotype DX, Prolaris, ProMark, Decipher), as well as potentially predictive but still experimental classifications (PAM50, PSC). Finally, we highlight specific genetic alteration (BRCA, MSI, NTRK) with concrete therapeutic implications.