前列腺癌（PCa）是全世界男性中最常见的恶性肿瘤。通过雄激素受体信号抑制剂（ARSI）治疗，患者最终死于去势抵抗性前列腺癌（CRPC）。为此，前列腺癌干细胞（PCSC）作为一种可促进肿瘤复发、ARSI抵抗和疾病进展的少数肿瘤细胞群体，正在引起人们的关注。因此，针对 PCSC 的特异性治疗具有势头。本研究回顾了 PCSC 和基于 PCSC 的假定生物标志物的鉴定和表征，并总结了它们的作用机制。我们从机制的角度进一步讨论了新型治疗干预措施的临床试验，重点关注 PCSC 相关途径、PCSC 微环境、尖端 miRNA 治疗和免疫治疗方法。这篇综述提供了对 PCSC 可塑性的最新见解，确定了新的 PCSC 生物标志物以及针对晚期 PCa 患者的优化治疗方法。版权所有 © 2024 Su、Huang、Zhou 和 Yang。

Prostate cancer (PCa) is the most common malignancy among men worldwide. Through androgen receptor signaling inhibitor (ARSI) treatment, patients eventually succumb to castration-resistant prostate cancer (CRPC). For this, the prostate cancer stem cells (PCSCs), as a minor population of tumor cells that can promote tumor relapse, ARSI resistance, and disease progression, are gaining attention. Therefore, specific therapy targeting PCSCs has momentum. This study reviewed the identification and characterization of PCSCs and PCSC-based putative biomarkers and summarized their mechanisms of action. We further discussed clinical trials of novel therapeutic interventions focused on PCSC-related pathways, the PCSC microenvironment, cutting-edge miRNA therapy, and immunotherapy approaches from a mechanistic standpoint. This review provides updated insights into PCSC plasticity, identifying new PCSC biomarkers and optimized treatments for patients with advanced PCa.Copyright © 2024 Su, Huang, Zhou and Yang.