Castrate-tolerant cells: what are the implications for the treatment of localized prostate cancer?

More effective treatment of prostate cancer relies on eliminating cells that survive androgen withdrawal therapy. The discovery that castrate-tolerant tumour cells pre-exist in localized prostate cancer, prior to androgen withdrawal or progression to castrate-resistant disease, supports the notion that neo-adjuvant therapies might be considered in the management of early stage prostate cancer. Advances in our ability to xenograft human prostate cancer provides a unique model system to study individual patient responses and test the preclinical efficacy of novel compounds for men with localized disease.