ABSTRACT
Patients with metastatic prostate cancer and their physicians can choose among an unprecedented array of investigational therapeutics whose aim is to alter the basic biology of prostate cancer growth and the metastatic cascade. These drugs can target intracellular signaling, the androgen receptor (AR), apoptosis regulation, angiogenesis, immune surveillance, and other mechanisms of tumor growth and metastatic spread. They can also distinguish prostate cancer cells from normal tissues and can target the bone microenvironment. Many have enhanced antiproliferative or proapoptotic effects on tumor cells relative to normal tissues. Despite these advances in the clinical availability of biologic agents, novel cytotoxics, immunologic manipulations, and targeted therapies, the standard imaging tools to assess both the tumor itself and the effects of drugs on the tumor are relatively primitive.
