As the leading culprit in cancer incidence for American men, prostate cancer continues to pose significant diagnostic, prognostic, and therapeutic tribulations for clinicians. The vast spectrum of disease behavior warrants better molecular classification to facilitate the development of more robust biomarkers that can identify the more aggressive and clinically significant tumor subtypes that require treatment. The untranslated portion of the human transcriptome, namely noncoding RNAs (ncRNA), is emerging as a key player in cancer initiation and progression and boasts many attractive features for both biomarker and therapeutic research. Genetic linkage studies show that many ncRNAs are located in cancer-associated genomic regions that are frequently deleted or amplified in prostate cancer, whereas aberrant ncRNA expression patterns have well-established links with prostate tumor cell proliferation and survival. The dysregulation of pathways controlled by ncRNAs results in a cascade of multicellular events leading to carcinogenesis and tumor progression. The characterization of RNA species, their functions, and their clinical applicability is a major area of biologic and clinical importance. This review summarizes the growing body of evidence, supporting a pivotal role for ncRNAs in the pathogenesis of prostate cancer. We highlight the most promising ncRNA biomarkers for detection and risk stratification and present the state-of-play for RNA-based personalized medicine in treating the "untreatable" prostate tumors. Clin Cancer Res; 20(1); 35-43. Ó2013 AACR.
Disclosure of Potential Conflicts of InterestNo potential conflicts of interest were disclosed.
CME Staff Planners' DisclosuresThe members of the planning committee have no real or apparent conflict of interest to disclose.
Learning Objective(s)Upon completion of this article, the reader should have a good understanding of the major small and long noncoding RNAs involved in prostate carcinogenesis, their potential as biomarkers, and the biologic rationale underlying novel therapeutic strategies using noncoding RNAs for castration-resistant prostate cancer.