A Novel Insight Into CRPC Progression and Immune: Evidence From Single-cell Spatial Transcriptome Multi-omics

Inclusion criteria

• Male patients, age >18 and <85 years.
• Histologically confirmed prostate adenocarcinoma, ductal adenocarcinoma, or intraductal carcinoma.
• Evidence of distant metastases by imaging (according to RECIST criteria).
• No prior systemic therapy for prostate cancer (no ADT or other systemic treatments).
• ECOG performance status 0-2 and estimated life expectancy >6 months.
• Adequate organ function as indicated by:

• Hemoglobin ≥ 90 g/L

• ANC ≥ 1.5 × 10^9/L

• Platelet count ≥ 75 × 10^9/L

• WBC ≥ 3 × 10^9/L ⑤ Total bilirubin ≤ ULN ⑥ ALT/AST ≤ 2.5 × ULN ⑦ Creatinine clearance ≥ 30 mL/min (Cockcroft-Gault formula)

• INR ≤ 1.5 or PT < 4 sec above ULN
• Ability to provide written informed consent.

Exclusion criteria

• Histological diagnosis of neuroendocrine or small-cell prostate cancer.
• No evidence of distant metastases on imaging.
• Prior systemic therapy for prostate cancer (neoadjuvant, adjuvant, or systemic).
• Severe endocrine, metabolic, gastrointestinal, hepatic, or renal disease (including chronic hepatitis, cirrhosis, chronic nephritis, or renal failure).
• History of immunodeficiency, including HIV positivity, congenital immunodeficiency, or organ transplantation.
• History of other malignancies (except non-melanoma skin cancer).
• Concurrent participation in another clinical trial.
• Inability to provide clinical information or anticipated loss to follow-up.
• Any condition deemed unsuitable for study participation by the investigator.