madman
Super Moderator
Abstract
Purpose: Detecting prostate cancer, developing therapeutic plans after negative biopsies, and prognosis-based patient counseling can be challenging for many urologists dealing with prostate cancer-specific antigens. New Biomarkers advances made improvements for the prediction of responses to therapeutic options and can tell us about survival and recurrence. In this review, we have assessed current and upcoming biomarkers that are opening a new era in diagnosing the disease.
Materials and Methods: We conducted a comprehensive literature review of studies describing prostate cancer biomarkers. Two independent investigators searched PubMed, Embase, Web of Science, and Cochrane Databases to identify biomarkers in prostate cancer conducted a literature review.
Results: Recently, combining prostate cancer-specific biomarkers into a single test has gained increasing attention, especially since the introduction of genomic and molecular tools. The development of the Prostate Health Index (PHI), SelectMDx, and Confirm MDx has shown promising results for prostate cancer detection, in addition to risk stratification and biopsy avoidance.
Conclusion: Despite major improvements and innovations in prostate cancer biomarkers, application in current clinical practice is limited. However, these biomarkers have an important role in determining risk, preventing unnecessary prostate biopsies, and predicting prognoses. Additional confirmatory studies will be needed to fully understand the impact of prostate cancer-specific biomarkers.
Introduction
Prostate cancer is one of the most common cancers and the fifth-leading cause of cancer-related mortality in men. (1) This is compounded by the fact that prostate cancer incidence is increasing, especially in countries with higher socioeconomic development. However, global mortality rates have only marginally improved. (2) There is a considerable debate concerning the role that current prostate-specific cancer biomarkers have in decreasing mortality rates. Issues include overdiagnosis and biopsies with negative results or indolent cancers that can cause complications. This has led many to suspect that biomarkers have only a small effect on patient survival. (3) Finding new and better genomic and biochemical markers to detect those at high risk of prostate adenocarcinoma is therefore essential. It is also important to differentiate benign and aggressive tumors and biomarkers that contribute to decision making after biopsy are required. Finally, more biomarkers that are accurate will allow a better discussion with patients concerning prognosis, enabling medical practitioners to develop the most effective therapeutic plans as shown in Images 1 and 2. Therefore, the purpose of this review is to provide an up-to-date assessment of new and upcoming prostate-specific cancer biomarkers to help clinicians and patients come to the best possible treatment decisions.
*Biomarkers that aid in reducing unnecessary biopsies
*Mixed Biomarkers
*Prostate Health Index (PHI)
*Prostate-specific membrane antigen (PSMA)
*Prostate cancer antigen 3 (PCA3)
*TMPRSS2:ERG gene fusions
*EXO106 score
*ExoDx Prostate (IntelliScore)
*Decipher
*SelectMDx
*Michigan Prostate Score (MiPS)
*Oncotype DX and Prolaris
*Other genes and single nucleotide polymorphisms (SNPs)
*Epigenetic alterations
*ConfirmMDx
*Biomarkers for predicting prognosis
*PORTOS
*ProMark
*DNA-ploidy
*Tumor circulating cells
Summary
Despite major developments in biomarkers, it is clear that additional work and a more focused clinical trial design are required to develop effective diagnostic tests for prostate cancer that have prognostic capacity. It is therefore additional large, multi-center clinical studies are needed to provide more vigorous evidence that will aid the development of prostate cancer biomarkers and to further validate these findings.
Purpose: Detecting prostate cancer, developing therapeutic plans after negative biopsies, and prognosis-based patient counseling can be challenging for many urologists dealing with prostate cancer-specific antigens. New Biomarkers advances made improvements for the prediction of responses to therapeutic options and can tell us about survival and recurrence. In this review, we have assessed current and upcoming biomarkers that are opening a new era in diagnosing the disease.
Materials and Methods: We conducted a comprehensive literature review of studies describing prostate cancer biomarkers. Two independent investigators searched PubMed, Embase, Web of Science, and Cochrane Databases to identify biomarkers in prostate cancer conducted a literature review.
Results: Recently, combining prostate cancer-specific biomarkers into a single test has gained increasing attention, especially since the introduction of genomic and molecular tools. The development of the Prostate Health Index (PHI), SelectMDx, and Confirm MDx has shown promising results for prostate cancer detection, in addition to risk stratification and biopsy avoidance.
Conclusion: Despite major improvements and innovations in prostate cancer biomarkers, application in current clinical practice is limited. However, these biomarkers have an important role in determining risk, preventing unnecessary prostate biopsies, and predicting prognoses. Additional confirmatory studies will be needed to fully understand the impact of prostate cancer-specific biomarkers.
Introduction
Prostate cancer is one of the most common cancers and the fifth-leading cause of cancer-related mortality in men. (1) This is compounded by the fact that prostate cancer incidence is increasing, especially in countries with higher socioeconomic development. However, global mortality rates have only marginally improved. (2) There is a considerable debate concerning the role that current prostate-specific cancer biomarkers have in decreasing mortality rates. Issues include overdiagnosis and biopsies with negative results or indolent cancers that can cause complications. This has led many to suspect that biomarkers have only a small effect on patient survival. (3) Finding new and better genomic and biochemical markers to detect those at high risk of prostate adenocarcinoma is therefore essential. It is also important to differentiate benign and aggressive tumors and biomarkers that contribute to decision making after biopsy are required. Finally, more biomarkers that are accurate will allow a better discussion with patients concerning prognosis, enabling medical practitioners to develop the most effective therapeutic plans as shown in Images 1 and 2. Therefore, the purpose of this review is to provide an up-to-date assessment of new and upcoming prostate-specific cancer biomarkers to help clinicians and patients come to the best possible treatment decisions.
*Biomarkers that aid in reducing unnecessary biopsies
*Mixed Biomarkers
*Prostate Health Index (PHI)
*Prostate-specific membrane antigen (PSMA)
*Prostate cancer antigen 3 (PCA3)
*TMPRSS2:ERG gene fusions
*EXO106 score
*ExoDx Prostate (IntelliScore)
*Decipher
*SelectMDx
*Michigan Prostate Score (MiPS)
*Oncotype DX and Prolaris
*Other genes and single nucleotide polymorphisms (SNPs)
*Epigenetic alterations
*ConfirmMDx
*Biomarkers for predicting prognosis
*PORTOS
*ProMark
*DNA-ploidy
*Tumor circulating cells
Summary
Despite major developments in biomarkers, it is clear that additional work and a more focused clinical trial design are required to develop effective diagnostic tests for prostate cancer that have prognostic capacity. It is therefore additional large, multi-center clinical studies are needed to provide more vigorous evidence that will aid the development of prostate cancer biomarkers and to further validate these findings.
