Contemporary molecular tests for prognosis and treatment guidance for castration-resistant prostate cancer.

INTRODUCTION: Currently, clinical factors related to the malignancy and patient-related factors such as performance status and comorbidities are employed to select agents to treat metastatic castration resistant prostate cancer (mCRPC). Areas covered: This paper covers emerging molecular panels that may be used in the clinic as prognostic or predictive biomarkers to treat mCRPC. Expert commentary: The expression of androgen receptor variant (AR-V)-7 in circulating tumor cells appears especially promising to select patients for taxane chemotherapy versus androgen inhibitors, abiraterone and enzalutamide. Additionally, the presence of DNA repair alterations such as BRCA alterations are rapidly emerging as a predictive biomarker to develop precision medicine using PARP inhibitors for these patients.