Biología molecular del cáncer de próstata

Molecular biology of prostate cancer

Publicado 2026-02-17

Resumen gráfico Biología molecular del cáncer de próstata
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Rojas-Puentes LL, Chavarriaga-Soto J, Zuluaga JA, Vargas C, Bourlon MT. Biología molecular del cáncer de próstata. Rev. colomb. hematol. oncol. [Internet]. 2026 Feb. 17 [cited 2026 Feb. 17];13(1-Supl):330-52. https://doi.org/10.51643/22562915.854

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Vol. 13 Núm. 1-Supl (2026): Biología molecular tumoral: de la básica a la clínica
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Rojas-Puentes LL, Chavarriaga-Soto J, Zuluaga JA, Vargas C, Bourlon MT. Biología molecular del cáncer de próstata. Rev. colomb. hematol. oncol. [Internet]. 2026 Feb. 17 [cited 2026 Feb. 17];13(1-Supl):330-52. https://doi.org/10.51643/22562915.854
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Luis Leonardo Rojas-Puentes
Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Bogotá, Colombia
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Perfil Google Scholar
https://orcid.org/0000-0002-7865-5424
Julian Chavarriaga-Soto
Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Bogotá, Colombia
Roles:  
https://orcid.org/0000-0003-0363-5485
Jairo Andrés Zuluaga
Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC) Bogotá, Colombia
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https://orcid.org/0009-0002-7534-5153
Carlos Vargas
Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer (FICMAC), Bogotá, Colombia
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https://orcid.org/0000-0002-6076-8260
María T. Bourlon
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán image/svg+xml
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https://orcid.org/0000-0002-3116-912X
Mostrar biografía de los autores

Luis Leonardo Rojas-Puentes,

Médico y Cirujano. Especialista en Medicina Interna. Especialista en Oncología Médica (Clínica). Magister en Epidemiología Clínica.

Julian Chavarriaga-Soto,

Urólogo oncólogo SUO Fellowship at The University of Toronto.

Jairo Andrés Zuluaga,

Médico y Cirujano. Especialista en Medicina Interna. Subespecialización en Oncología Clínica.

Carlos Vargas,

Especialista en Oncología Médica y Miembro fundador de la Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer (FICMAC).

María T. Bourlon,

Médico Cirujano, Universidad Panamericana. Especialidad en Medicina Interna. Subespecialidad en Oncología Médica en el Instituto de Ciencias Médicas y Nutrición Salvador Zubirán. Profesor de la Escuela de Medicina de la Universidad Panamericana.

Introducción: el cáncer de próstata (CaP) es la neoplasia maligna más frecuente en hombres y una causa relevante de mortalidad oncológica mundial. Su heterogeneidad, desde tumores indolentes hasta formas agresivas, dificulta la estratificación del riesgo y la selección terapéutica, pero los avances en biología molecular han aclarado las alteraciones genómicas y epigenéticas implicadas en la tumorogénesis, progresión y resistencia, impulsando la medicina de precisión.

Métodos: se realizó una revisión narrativa de la literatura sobre vías moleculares clave, alteraciones genómicas clínicamente relevantes y estrategias terapéuticas emergentes basadas en biomarcadores en CaP localizado y metastásico.

Resultados: las mutaciones germinales y somáticas en genes de reparación del ADN, como BRCA1, BRCA2 y ATM, se relacionan con mayor susceptibilidad, fenotipos agresivos y sensibilidad a inhibidores PARP y esquemas con platino. La pérdida de genes supresores tumorales (PTEN, TP53, RB1) favorece la inestabilidad genómica, la resistencia a la castración y un pronóstico desfavorable. Los clasificadores genómicos (Oncotype DX, Decipher) refinan la estratificación del riesgo y orientan la intensificación o desescalamiento terapéutico en enfermedad localizada, mientras que el testeo genético reflejo y los estudios clínicos dirigidos por biomarcadores ejemplifican la integración clínica de la información molecular. En enfermedad avanzada, terapias dirigidas al receptor androgénico, a la reparación del ADN y al PSMA están transformando el manejo del CaP.

Conclusiones: la caracterización molecular del CaP permite intervenciones guiadas por biomarcadores que optimizan las decisiones terapéuticas y los desenlaces clínicos. La incorporación sistemática del perfil genómico será esencial para consolidar la medicina de precisión en el tratamiento. 

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