Although localized prostate cancer(PCa)can be cured by prostatectomy and radiotherapy,the development of effective therapeutic approaches for advanced prostate cancer,including castration-resistant PCa(CRPC)and neuroendocrine PCa(NEPC),is lagging far behind.Identifying a novel prognostic and diagnostic biomarker for early diagnosis and intervention is an urgent clinical need.Here,we report that apolipoprotein A-I(ApoA-I),the major component of high-density lipoprotein(HDL),is upregulated in PCa based on both bioinformatics and experimental evidence.The fact that advanced PCa shows strong ApoA-l expression reflects its potential role in driving therapeutic resistance and disease progression by reprogramming the lipid metabolic network of tumor cells.Molecularly,ApoA-I is regulated by MYC,a frequently amplified oncogene in late-stage PCa.Altogether,our findings have revealed a novel indicator to predict prognosis and recurrence,which would benefit patients who are prone to progress to metastasis or even NEPC,which is the lethal subtype of PCa.