1️⃣ Next-generation endocrine agents

  • Oral SERDs (elacestrant, camizestrant) → better bioavailability, ER mutant activity.

  • PROTAC degraders (target ER or AR for ubiquitin destruction).

  • Selective AR degraders (SARDs) for castration-resistant prostate cancer.

2️⃣ Combination innovations

  • Radioligand therapy (177Lu-PSMA) + ADT or AR blockers → synergistic in mCRPC.

  • PARP inhibitors + AR blockade for BRCA-mutated cases.

  • Endocrine + Immunotherapy being explored in ER-positive MSI-H tumors.

3️⃣ Personalization via biomarkers

  • ESR1, PIK3CA, AR-V7 testing guides drug choice.

  • Liquid biopsy for ctDNA mutation tracking.

  • Machine-learning models predicting AI response under trial.

4️⃣ Patient-centric models

  • Long-acting oral formulations → home adherence programs.

  • Telemonitoring of BP, weight, mood, DEXA reminders.

(ESMO Innovation Summit 2025)

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