Prostate cancer remains one of the most actual problems in oncourology due to its high prevalence and resistance to therapy. Within 5 years of active treatment and follow-up, the castration-resistant prostate cancer (CRPC) develops in 10-20% of patients. This type of disease course resists treatments and leads to death. Medical resources distinguish two different forms of CRPC: non-metastatic and metastatic. Such separation is critically important because each of two forms requires different treatment algorithms. This paper summarizes the main outlines of foreign clinical guidelines and reviews the new treatment options for non-metastatic and metastatic CRPC as wells as the design and results of key clinical trials on drug efficiency. To prepare the review, the comprehensive literature search was conducted using PubMed/Medline, the Cochrane Library, EMBASE, CyberLeninka, e-library databases. The search line included phrases containing the following words: prostate cancer, castration-resistant prostate cancer, drug therapy, treatment algorithms, clinical studies, etc. In accordance to foreign guidelines, it is essential to determine the high risk patients with non-metastatic CRPC and promptly apply new therapeutic options including apalutamide and enzalutamide, which have proven being effective in clinical trials as therapies that attenuate the transition of the non-metastatic CRPC to the metastatic stage. Foreign medical guidelines propose to apply a wider set of treatment algorithms for patients with metastatic CRPC, for instance: considerations on possibilities to use the cabazitaxel instead of docetaxel in the 1st line therapy in patients with pre-existing mild peripheral neuropathy, etc. as well as new therapies - pembrolizumab and sipuleucel-T. The issues regarding the selection of patients with CRPC for specific treatment algorithms and defining the optimal sequence of therapeutic regimens as well as combining various regimens with minimizing toxic effects and maximizing patient benefits remain unsolved.

BACKGROUND: Prostate carcinoma is a serious social and economic problem; it ranks second among the most frequently diagnosed malignant tumors worldwide and it ranks sixth in the structure of causes of death from cancer in men. The correct organization of prevention and screening as well as the use of the latest methods of clinical instrumental and molecular analysis at all stages of treatment and diagnostic process can fundamentally improve the outcomes of the disease. AIM: This study aimed to analyze of the best international experience in the development of basic clinical and instrumental test packages that determine the personalized choice of medical prescriptions for the treatment and diagnostic process of prostate cancer. METHODS: The study included papers published after January 1, 2008, with an emphasis on the analysis of results posted in the last 2 years in the PubMed/Medline electronic database as reliable sources of information. RESULTS AND DISCUSSION: This study explored the basic structural model of the formation of clinical and diagnostic packages at the implementation of a personalized treatment and diagnostic process in prostate cancer. The main biomarkers of prostate cancer used in clinical practice have been identified, and the informative value of the newest biomarker tests has been established. Diagnostic tools that are ready for wider implementation in oncological practice are predictive models, such as the 4K algorithm, Score, SelectMDx, Stockholm-3 model, justifying the need to perform a prostate biopsy in a particular patient. Some promising biomarker characteristics of prostate cancer, assessed at the nonclinical, experimental stage, have been demonstrated. CONCLUSIONS: This study found that (1) Revision of the algorithms for personalized treatment is becoming an important element in the provision of patient-oriented cancer care. (2) Periodic reassessment of the individual portrait of the tumor process is necessary for the correct organization of treatment and diagnostic measures in a particular patient. (3) Finally, for the implementation of the whole range of possibilities of individual treatment, close interaction with the representatives of various medical specialties in the framework of the implementation of translational medicine programs in oncologyis important.