A Prospective Study Based on Spatial Multi-omics to Predict the Efficacy of ADT Combined With Second-generation Novel Hormonal Agents in Metastatic Hormone-sensitive Prostate Cancer.

1、Baseline sample collection: Tumor tissues will be collected via prostate biopsy fromenrolled patients. The specimens will be tripartite: one aliquot for standardhistopathology, one for WES, and one for spatial multi‐omic profiling (Xenium andPhenoCycler‐Fusion).2、Follow‐up: Patients will be assessed every 3 months during therapy,with CBC, biochemistry, sex hormones, and serum PSA. Prostate mpMRI will be repeatedevery 3 months. PSA testing frequency may be modified if PSA progression occurs.Follow‐up continues until CRPC development or death.3、（1）Primary: Build a prognosticmodel integrating Xenium, WES, and PCF data.（2）Secondary: bPFS and OS.（3）Progression: PSArise to ≥0.2 ng/mL confirmed on repeat testing after prior undetectable levels.