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

Inclusion Criteria:

1. Male patients, age \>18 and \<85 years.
2. Histologically confirmed prostate adenocarcinoma, ductal adenocarcinoma, or intraductal carcinoma.
3. Evidence of distant metastases by imaging (according to RECIST criteria).
4. No prior systemic therapy for prostate cancer (no ADT or other systemic treatments).
5. ECOG performance status 0-2 and estimated life expectancy \>6 months.
6. 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
7. Ability to provide written informed consent.

Exclusion Criteria:

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