Prostate cancer (PCa) is one of the most prevalent malignancies in men worldwide. Its progression is not only driven by molecular and genetic alterations but also significantly influenced by mechanical cues in the tumor microenvironment. Biomechanics, an interdis-ciplinary field exploring the role of physical forces in biological systems, has emerged as a novel lens for cancer research. This review summarizes recent advances in the bio-mechanical study of PCa, including tissue stiffness heterogeneity, cellular mechanical phenotypes, extracellular matrix remodeling, and fluid shear stress in tumor progression. We further highlight the clinical implications of biomechanics in early detection, be-nign–malignant lesion discrimination, and multi-modal diagnostic imaging. Moreover, the therapeutic potential of biomechanical approaches was discussed, including modulation of therapeutic sensitivity, targeting mechano-signaling pathways, developing mechanically responsive nanocarriers, and applying external mechanical interventions. Despite current challenges such as a lack of standardization and limited clinical translation, inter-disciplinary collaboration holds promise for advancing biomechanically informed precision medicine in PCa.
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Biomechanical perspective of prostate cancer: pathological mechanism, diagnostic innovation and targeted intervention
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1. Zhang Y, Rumgay H, Li M, et al. Nasopharyngeal cancer incidence and mortality in 185 countries in 2020 and the projected burden in 2040: population-based global epidemiological profiling[J]. JMIR Public Health Surveill, 2023, 9: e49968.
2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Sekhoacha M, Riet K, Motloung P, et al. Prostate cancer review: genetics, diagnosis, treatment options, and alternative approaches[J]. Molecules, 2022, 27(17): 5730.
4. Raudenska M, Kratochvilova M, Vicar T, et al. Cisplatin enhances cell stiffness and decreases invasiveness rate in prostate cancer cells by actin accumulation[J]. Sci Rep, 2019, 9(1): 1660.
5. Jasuja H, Jaswandkar SV, Katti DR, et al. Interstitial fluid flow contributes to prostate cancer invasion and migration to bone; study conducted using a novel horizontal flow bioreactor[J]. Biofabrication, 2023, 15(2): 025017.
6. Tang X, Zhang Y, Mao J, et al. Effects of substrate stiffness on the viscoelasticity and migration of prostate cancer cells examined by atomic force microscopy[J]. Beilstein J Nanotechnol, 2022, 13: 560-569.
7. Plodinec M, Loparic M, Monnier CA, et al. The nanomechanical signature of breast cancer[J]. Nat Nanotechnol, 2012, 7(11): 757-765.
8. Tseng JC, Wang BJ, Wang YP, et al. Caffeic acid phenethyl ester suppresses EGFR/FAK/Akt signaling, migration, and tumor growth of prostate cancer cells[J]. Phytomedicine, 2023, 116: 154860.
9. Matoso A, Epstein JI. Grading of prostate cancer: past, present, and future[J]. Curr Urol Rep, 2016, 17(3): 25.
10. Lu P, Weaver VM, Werb Z. The extracellular matrix: a dynamic niche in cancer progression[J]. J Cell Biol, 2012, 196(4): 395-406.
11. Yang Y, Zhao X, Zhao X, et al. Value of shear wave elastography for diagnosis of primary prostate cancer: a systematic review and Meta-analysis[J]. Med Ultrason, 2019, 21(4): 382-388.
12. Ageeli W, Zhang X, Ogbonnaya CN, et al. Multimodality characterization of cancer-associated fibroblasts in tumor microenvironment and its correlation with ultrasound shear wave-measured tissue stiffness in localized prostate cancer[J]. Front Oncol, 2022, 12: 822476.
13. Surov A, Meyer HJ, Wienke A. Correlations between apparent diffusion coefficient and gleason score in prostate cancer: a systematic review[J]. Eur Urol Oncol, 2020, 3(4): 489-497.
14. Swanson GP, Trevathan S, Hammonds KAP, et al. Gleason score evolution and the effect on prostate cancer outcomes[J]. Am J Clin Pathol, 2021, 155(5): 711-717.
15. Lopez-Cavestany M, Hahn SB, Hope JM, et al. Matrix stiffness induces epithelial-to-mesenchymal transition via Piezo1-regulated calcium flux in prostate cancer cells[J]. iScience, 2023, 26(4): 106275.
16. Wen S, Shang Z, Zhu S, et al. Androgen receptor enhances entosis, a non-apoptotic cell death, through modulation of Rho/ROCK pathway in prostate cancer cells[J]. Prostate, 2013, 73(12): 1306-1315.
17. Lee YC, Lin SC, Yu G, et al. Prostate tumor-induced stromal reprogramming generates Tenascin C that promotes prostate cancer metastasis through YAP/TAZ inhibition[J]. Oncogene, 2022, 41(6): 757-769.
18. Samaržija I. The Potential of extracellular matrix- and integrin adhesion complex-related molecules for prostate cancer biomarker discovery[J]. Biomedicines, 2023, 12(1): 79.
19. Ding SM, Lu AL, Lu JF, et al. Macrovascular endothelial cells enhance the motility of liver cancer cells by up-regulation of MMP-3, activation of integrin/FAK signaling pathway and induction of non-classical epithelial-mesenchymal transition[J]. J Cancer, 2020, 11(8): 2044-2059.
20. Piranfar A, Moradi Kashkooli F, Zhan W, et al. A comparative analysis of alpha and beta therapy in prostate cancer using a 3D image-based spatiotemporal model[J]. Ann Biomed Eng, 2025, 53(3): 562-577.
21. Gu Q, Dockery L, Daniel MC, et al. Nanoparticle delivery in prostate tumors implanted in mice facilitated by either local or whole-body heating[J]. Fluids (Basel), 2021, 6(8): 272.
22. Hope JM, Bersi MR, Dombroski JA, et al. Circulating prostate cancer cells have differential resistance to fluid shear stress-induced cell death[J]. J Cell Sci, 2021, 134(4): jcs251470.
23. Akerkouch L, Jasuja H, Katti K, et al. The influence of fluid shear stress on bone and cancer cells proliferation and distribution[J]. Ann Biomed Eng, 2023, 51(6): 1199-1215.
24. Grigoryeva ES, Savelieva OE, Popova NO, et al. Do tumor exosome integrins alone determine organotropic metastasis?[J]. Mol Biol Rep, 2020, 47(10): 8145-8157.
25. Hoshino A, Costa-Silva B, Shen TL, et al. Tumour exosome integrins determine organotropic metastasis[J]. Nature, 2015, 527(7578): 329-335.
26. Obiora D, Orikogbo O, Davies BJ, et al. Controversies in prostate cancer screening[J]. Urol Oncol, 2025, 43(1): 49-53.
27. Molter CW, Muszynski EF, Tao Y, et al. Prostate cancer cells of increasing metastatic potential exhibit diverse contractile forces, cell stiffness, and motility in a microenvironment stiffness-dependent manner[J]. Front Cell Dev Biol, 2022, 10: 932510.
28. Kim SH, Kim JY, Hwang MJ. Magnetic resonance elastography for the detection and classification of prostate cancer[J]. Cancers (Basel), 2024, 16(20): 3494.
29. Zeng J, Zhang Y, Xu R, et al. Nanomechanical-based classification of prostate tumor using atomic force microscopy[J]. Prostate, 2023, 83(16): 1591-1601.
30. Sassi A, You L. Microfluidics-based technologies for the assessment of castration-resistant prostate cancer[J]. Cells, 2024, 13(7): 575.
31. Amer M, Wolfenson H. Measuring cellular traction forces with micropillar arrays[J]. Methods Mol Biol, 2023, 2600: 197-206.
32. Schoen I, Hu W, Klotzsch E, et al. Probing cellular traction forces by micropillar arrays: contribution of substrate warping to pillar deflection[J]. Nano Lett, 2010, 10(5): 1823-1830.
33. Kader A, Snellings J, Adams LC, et al. Sensitivity of magnetic resonance elastography to extracellular matrix and cell motility in human prostate cancer cell line-derived xenograft models[J]. Biomater Adv, 2024, 161: 213884.
34. Dias AB, O'Brien C, Correas JM, et al. Multiparametric ultrasound and micro-ultrasound in prostate cancer: a comprehensive review[J]. Br J Radiol, 2022, 95(1131): 20210633.
35. Chen J, Chen Y, Chen G, et al. Magnetic resonance elastography combined with PI-RADS v2.1 for the identification of clinically significant prostate cancer[J]. J Magn Reson Imaging, 2025, 61(5): 2248-2257.
36. Wei C, Zhang Y, Zhang X, et al. Prostate cancer gleason score from biopsy to radical surgery: can ultrasound shear wave elastography and multiparametric magnetic resonance imaging narrow the gap?[J]. Front Oncol, 2021, 11: 740724.
37. Mannaerts CK, Wildeboer RR, Remmers S, et al. Multiparametric ultrasound for prostate cancer detection and localization: correlation of B-mode, shear wave elastography and contrast enhanced ultrasound with radical prostatectomy specimens[J]. J Urol, 2019, 202(6): 1166-1173.
38. Murphy JE, Wo JY, Ryan DP, et al. Total neoadjuvant therapy with folfirinox in combination with losartan followed by chemoradiotherapy for locally advanced pancreatic cancer: a phase 2 clinical trial[J]. JAMA Oncol, 2019, 5(7): 1020-1027.
39. Qin X, Lv X, Li P, et al. Matrix stiffness modulates ILK-mediated YAP activation to control the drug resistance of breast cancer cells[J]. Biochim Biophys Acta Mol Basis Dis, 2020, 1866(3): 165625.
40. Rice AJ, Cortes E, Lachowski D, et al. Matrix stiffness induces epithelial-mesenchymal transition and promotes chemoresistance in pancreatic cancer cells[J]. Oncogenesis, 2017, 6(7): e352.
41. Sulzmaier FJ, Jean C, Schlaepfer DD. FAK in cancer: mechanistic findings and clinical applications[J]. Nat Rev Cancer, 2014, 14(9): 598-610.
42. Ocak S, Chen H, Callison C, et al. Expression of focal adhesion kinase in small-cell lung carcinoma[J]. Cancer, 2012, 118(5): 1293-1301.
43. Flockerzi FA, Hohneck J, Saar M, et al. SCARA5 is overexpressed in prostate cancer and linked to poor prognosis[J]. Diagnostics (Basel), 2023, 13(13): 2211.
44. Wang-Gillam A, Lim KH, McWilliams R, et al. Defactinib, pembrolizumab, and gemcitabine in patients with advanced treatment refractory pancreatic cancer: a phase i dose escalation and expansion study[J]. Clin Cancer Res, 2022, 28(24): 5254-5262.
45. Paindelli C, Casarin S, Wang F, et al. Enhancing (223)ra treatment efficacy by anti-β1 integrin targeting[J]. J Nucl Med, 2022, 63(7): 1039-1045.
46. Korin N, Kanapathipillai M, Matthews BD, et al. Shear-activated nanotherapeutics for drug targeting to obstructed blood vessels[J]. Science, 2012, 337(6095): 738-742.
47. Jiang X, Xu S, Miao Y, et al. Curvature-mediated rapid extravasation and penetration of nanoparticles against interstitial fluid pressure for improved drug delivery[J]. Proc Natl Acad Sci U S A, 2024, 121(22): e2319880121.
48. Zhao G, Zeng Y, Cheng W, et al. Peptide-modified lipid nanoparticles boost the antitumor efficacy of RNA therapeutics[J]. ACS Nano, 2025, 19(14): 13685-13704.
49. Xia C, Zeng H, Zheng Y. Low-intensity ultrasound enhances the antitumor effects of doxorubicin on hepatocellular carcinoma cells through the ROS-miR-21-PTEN axis[J]. Mol Med Rep, 2020, 21(3): 989-998.
50. Dimcevski G, Kotopoulis S, Bjånes T, et al. A human clinical trial using ultrasound and microbubbles to enhance gemcitabine treatment of inoperable pancreatic cancer[J]. J Control Release, 2016, 243: 172-181.
51. Almasri F, Sakarya EH, Karshafian R. Radioenhancement with the combination of docetaxel and ultrasound microbubbles: in vivo prostate cancer[J]. Pharmaceutics, 2023, 15(5): 1468.
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