The evolution of ctDNA as a Predictive Biomarker of Response in Metastatic Castration Resistance Prostate Cancer Therapy

1. Abstract Circulating tumor DNA (ctDNA) is an emerging biomarker in cancer research and has shown promise in predicting response to therapy in several malignancies, including metastatic castration- resistant prostate cancer (mCRPC). In mCRPC, ctDNA has the po- tential to identify patients who are more likely to respond to specif- ic therapies based on the detection of specific genetic alterations. However, the use of ctDNA as a biomarker has several limitations, including the sensitivity of ctDNA detection and the subjectivi- ty of clonal evolution. Future research in ctDNA analysis should focus on developing standardized methods for ctDNA analysis, identifying additional genetic alterations associated with treatment response, and integrating ctDNA analysis with imaging and other biomarkers. Despite these limitations, the potential of ctDNA as a biomarker highlights the importance of precision medicine in prostate cancer treatment, where personalized treatment strategies can be tailored to the specific genetic profile of the patients tumor. Further investigation of ctDNA as a biomarker in prostate cancer will be critical to advancing personalized medicine and improving the lives of those living with mCRPC.