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Clinical and Novel Biomarkers in the Management of Prostate Cancer

  • Genitourinary Cancers (N Agarwal, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Clinical outcomes in prostate cancer after initial screening and treatment for organ-confined disease and in advanced stage after drug intervention can be heterogeneous. Serum prostate-specific antigen which has a modest value as a screening biomarker while widely used in practice in all subsequent stages has limitations for prognostication or prediction of drug efficacy. Recent advances in genomic sciences and the identification of the mutational landscape of organ-confined and advanced-stage disease have contributed to the development of molecular biomarker profiling in addition to serum prostate-specific antigen. Genomic biomarkers are in development for application to screening for lethal disease subtypes, monitoring of disease recurrence after initial treatments, prognostication, as well as for prediction of drug efficacy. The application of translational molecular profiling in prostate cancer has the potential to enhance clinical management and outcomes in the future. Molecular biomarkers in development in organ-confined disease include both DNA- and RNA-based candidate and pathway-based biomarkers. In advanced-stage disease, molecular biomarker profiling has emerged for identifying therapeutic targets, prediction of drug efficacy, and for prognostication of survival that includes germline single nucleotide profiling and somatic aberrations including copy number variation and mutations and RNA-based profiling. This review summarizes the current state of clinical biomarkers used in practice, their limitations, and novel molecular biomarkers being developed for several clinical endpoints in early- and late-stage cancer.

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Abbreviations

PSA:

Prostate-specific antigen

ERSPC:

European Randomized Study for Reducing Prostate Cancer

PLCO:

Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

USPTF:

US Preventive Task Force

Phi:

Prostate Health Index

PCA3:

Prostate cancer antigen 3

ETS:

E26 transformation-specific

TCGA:

The Cancer Genome Atlas

AR:

Androgen receptor

AMACR:

Alpha-methylacyl coenzyme A racemase

SNPs:

Single nucleotide polymorphisms

GS:

Gleason score

NCCN:

National Comprehensive Cancer Network

DRE:

Digital rectal examination

HNPC:

Hormone-naïve prostate cancer

ADT:

Androgen deprivation therapy

CRPC:

Castrate-resistant prostate cancer

CTCs:

Circulating tumor cells

AR-V:

Androgen receptor variant

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Authors and Affiliations

  1. Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Cristóbal Sanhueza MD & Manish Kohli MD

  2. Department of Oncology, Clínica Santa María, 500 Santa Maria Street, 7500000, Santiago, Chile

    Cristóbal Sanhueza MD

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  1. Cristóbal Sanhueza MD
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  2. Manish Kohli MD
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Correspondence to Manish Kohli MD.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding Support

This work was supported by a R01-CA21209 NCI grant and a Department of Defense W81XWH-15-1-0634 award to M.K.

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The article is part of the Topical Collection on Genitourinary Cancers

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Sanhueza, C., Kohli, M. Clinical and Novel Biomarkers in the Management of Prostate Cancer. Curr. Treat. Options in Oncol. 19, 8 (2018). https://doi.org/10.1007/s11864-018-0527-z

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