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Liu Y, Hatano K, Nonomura N. Liquid Biomarkers in Prostate Cancer Diagnosis: Current Status and Emerging Prospects. World J Mens Health 2024; 42:42.e45. [PMID: 38772530 DOI: 10.5534/wjmh.230386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 05/23/2024] Open
Abstract
Prostate cancer (PCa) is a major health concern that necessitates appropriate diagnostic approaches for timely intervention. This review critically evaluates the role of liquid biopsy techniques, focusing on blood- and urine-based biomarkers, in overcoming the limitations of conventional diagnostic methods. The 4Kscore test and Prostate Health Index have demonstrated efficacy in distinguishing PCa from benign conditions. Urinary biomarker tests such as PCa antigen 3, MyProstateScore, SelectMDx, and ExoDx Prostate IntelliScore test have revolutionized risk stratification and minimized unnecessary biopsies. Emerging biomarkers, including non-coding RNAs, circulating tumor DNA, and prostate-specific antigen (PSA) glycosylation, offer valuable insights into PCa biology, enabling personalized treatment strategies. Advancements in non-invasive liquid biomarkers for PCa diagnosis may facilitate the stratification of patients and avoid unnecessary biopsies, particularly when PSA is in the gray area of 4 to 10 ng/mL.
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Affiliation(s)
- Yutong Liu
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Koji Hatano
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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2
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Samare-Najaf M, Kouchaki H, Moein Mahini S, Saberi Rounkian M, Tavakoli Y, Samareh A, Karim Azadbakht M, Jamali N. Prostate cancer: Novel genetic and immunologic biomarkers. Clin Chim Acta 2024; 555:117824. [PMID: 38316287 DOI: 10.1016/j.cca.2024.117824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Prostate cancer (PCa) is considered one of the most prevalent male malignancies worldwide with a global burden estimated to increase over the next two decades. Due to significant mortality and debilitation of survival, early diagnosis has been described as key. Unfortunately, current diagnostic serum-based strategies have low specificity and sensitivity. Histologic examination is invasive and not useful for treatment and monitoring purposes. Hence, a plethora of studies have been conducted to identify and validate an efficient noninvasive approach in the diagnosis, staging, and prognosis of PCa. These investigations may be categorized as genetic (non-coding biomarkers and gene markers), immunologic (immune cells, interleukins, cytokines, antibodies, and auto-antibodies), and heterogenous (PSA-related markers, PHI-related indices, and urinary biomarkers) subgroups. This review examines current approaches and potential strategies using biomarker panels in PCa.
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Affiliation(s)
- Mohammad Samare-Najaf
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Hosein Kouchaki
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Moein Mahini
- Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Saberi Rounkian
- Student Research Committee, School of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Yasaman Tavakoli
- Department of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Ali Samareh
- Department of Clinical Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Navid Jamali
- Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran.
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3
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Baston C, Preda A, Iordache A, Olaru V, Surcel C, Sinescu I, Gingu C. How to Integrate Prostate Cancer Biomarkers in Urology Clinical Practice: An Update. Cancers (Basel) 2024; 16:316. [PMID: 38254807 PMCID: PMC10813985 DOI: 10.3390/cancers16020316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
Nowadays, the management of prostate cancer has become more and more challenging due to the increasing number of available treatment options, therapeutic agents, and our understanding of its carcinogenesis and disease progression. Moreover, currently available risk stratification systems used to facilitate clinical decision-making have limitations, particularly in providing a personalized and patient-centered management strategy. Although prognosis and prostate cancer-specific survival have improved in recent years, the heterogenous behavior of the disease among patients included in the same risk prognostic group negatively impacts not only our clinical decision-making but also oncological outcomes, irrespective of the treatment strategy. Several biomarkers, along with available tests, have been developed to help clinicians in difficult decision-making scenarios and guide management strategies. In this review article, we focus on the scientific evidence that supports the clinical use of several biomarkers considered by professional urological societies (and included in uro-oncological guidelines) in the diagnosis process and specific difficult management strategies for clinically localized or advanced prostate cancer.
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Affiliation(s)
- Catalin Baston
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.B.); (V.O.); (C.S.); (I.S.); (C.G.)
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Adrian Preda
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Alexandru Iordache
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Vlad Olaru
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.B.); (V.O.); (C.S.); (I.S.); (C.G.)
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Cristian Surcel
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.B.); (V.O.); (C.S.); (I.S.); (C.G.)
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Ioanel Sinescu
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.B.); (V.O.); (C.S.); (I.S.); (C.G.)
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Constantin Gingu
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.B.); (V.O.); (C.S.); (I.S.); (C.G.)
- Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
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4
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Campistol M, Triquell M, Regis L, Celma A, de Torres I, Semidey ME, Mast R, Mendez O, Planas J, Trilla E, Morote J. Relationship between Proclarix and the Aggressiveness of Prostate Cancer. Mol Diagn Ther 2023; 27:487-498. [PMID: 37081322 DOI: 10.1007/s40291-023-00649-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Proclarix is a CE-marked test that provides the risk of clinically significant prostate cancer (csPCa), ranging from 0% to 100%, based on the serum measurement of Thrombospondin-1, cathepsin D, prostate-specific antigen (PSA), and percentage of free PSA in addition to age. We hypothesize that Proclarix could be correlated with PCa aggressiveness. We analyzed the association of this new biomarker with four surrogates of aggressiveness: grade group (GG) in the biopsy, clinical stage, risk of biochemical recurrence after primary treatment of localized PCa, and pathology in the surgical specimen. MATERIAL AND METHODS This is a retrospective study from 606 men with suspicion of PCa [PSA of ≥ 3.0 ng/mL and/or abnormal digital rectal examination (DRE)], in whom Proclarix was assessed (0-100%). The GG was defined by the International Society of Urological Pathology categories. The TNM was used for clinical staging (cT based on DRE, whereas cN and cM were established with computed tomography and 99-technetium bone scintigraphy). The risk of biochemical recurrence of localized PCa after primary treatment was defined by combining PSA, GG, and cT. Finally, an unfavorable pathology in a surgical specimen was defined as GG > 2 or pT ≥ 3. RESULTS The median age of the cohort was 67 years old, with a median PSA of 7 ng/mL and a rate of abnormal DRE of 23.3%. CsPCa was detected in 254 men (41.9%), with a median Proclarix of 60.1% compared with 37.3% obtained in patients with insignificant PCa and 20.7% in men without PCa. Among patients with GG > 3, Proclarix was significantly higher (58.2%) than in those with GG of 3 or lower (33.1%, p < 0.001). Men with localized tumors exhibited a Proclarix median of 37.3% compared with those with advanced disease (60.1%, p < 0.001). Proclarix levels among 197 patients with low and intermediate risk of biochemical recurrence were 24.9% and 35.0%, respectively, significantly lower compared with patients with high-risk disease (58.7%, p < 0.001). Unfavorable pathology was observed in 35 patients out of the 79 who underwent radical prostatectomy, with a Proclarix median of 35.7% compared with 23.7% obtained in patients with favorable pathology (p = 0.013). Proclarix and magnetic resonance imaging were independent predictors of the four surrogates of aggressiveness analyzed. CONCLUSION There is a correlation between Proclarix and the aggressiveness of PCa.
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Affiliation(s)
- Miriam Campistol
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain.
- Department of Surgery, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain.
| | - Marina Triquell
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Lucas Regis
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
| | - Ana Celma
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
| | - Inés de Torres
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
- Department of Pathology, Vall d'Hebron Hospital, 08035, Barcelona, Spain
- Department of Morphological Sciences, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
| | - María E Semidey
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
- Department of Pathology, Vall d'Hebron Hospital, 08035, Barcelona, Spain
- Department of Morphological Sciences, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
| | - Richard Mast
- Department of Radiology, Vall d'Hebron Hospital, 08035, Barcelona, Spain
| | - Olga Mendez
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
| | - Jacques Planas
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
| | - Enrique Trilla
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
| | - Juan Morote
- Department of Urology, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
- Prostate Cancer Research Group, Vall d'Hebron, Research Institute, 08035, Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
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5
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Rasmussen M, Fredsøe J, Tin AL, Vickers AJ, Ulhøi B, Borre M, Eastham J, Ehdaie B, Guillonneau B, Laudone V, Scardino PT, Touijer K, Sørensen KD, Lilja H. Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence. Br J Cancer 2022; 126:1004-1009. [PMID: 34903844 PMCID: PMC8980060 DOI: 10.1038/s41416-021-01661-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/18/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP). METHODS We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately. RESULTS The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002, 0.016; clinical model AUC 0.767), driven by GG1 (delta AUC 0.040, 95% CI 0.006, 0.073) rather than GG2 patients (delta AUC 0.005, 95% CI -0.012, 0.021). Adding 4Kscore improved prediction of BCR in all patients (delta C-index 0.014, 95% CI 0.007, 0.021; preop-BCR nomogram C-index 0.738), again with larger changes in GG1 than in GG2. CONCLUSIONS This study validates prior investigations on the use of 4Kscore in men with biopsy-confirmed PC. Men with GG1 PC and a high 4Kscore may benefit from additional testing to guide treatment selection. Further research is warranted regarding the value of the 4Kscore in men with biopsy GG2 PC.
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Affiliation(s)
- Martin Rasmussen
- grid.154185.c0000 0004 0512 597XDepartment of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jacob Fredsøe
- grid.154185.c0000 0004 0512 597XDepartment of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Amy L. Tin
- grid.51462.340000 0001 2171 9952Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Andrew J. Vickers
- grid.51462.340000 0001 2171 9952Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Benedicte Ulhøi
- grid.154185.c0000 0004 0512 597XDepartment of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Borre
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - James Eastham
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Behfar Ehdaie
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Bertrand Guillonneau
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.6363.00000 0001 2218 4662Uro-Oncology Department, Charité University Hospital, Berlin, Germany
| | - Vincent Laudone
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Peter T. Scardino
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Karim Touijer
- grid.51462.340000 0001 2171 9952Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Karina D. Sørensen
- grid.154185.c0000 0004 0512 597XDepartment of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Hans Lilja
- grid.51462.340000 0001 2171 9952Departments of Laboratory Medicine, Surgery, and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.4514.40000 0001 0930 2361Department of Translational Medicine, Lund University, Malmö, Sweden
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6
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Falagario UG, Sanguedolce F, Dovey Z, Carbonara U, Crocerossa F, Papastefanou G, Autorino R, Recchia M, Ninivaggi A, Busetto GM, Annese P, Carrieri G, Cormio L. Prostate cancer biomarkers: a practical review based on different clinical scenarios. Crit Rev Clin Lab Sci 2022; 59:297-308. [PMID: 35200064 DOI: 10.1080/10408363.2022.2033161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Traditionally, diagnosis and staging of prostate cancer (PCa) have been based on prostate-specific antigen (PSA) level, digital rectal examination (DRE), and transrectal ultrasound (TRUS) guided prostate biopsy. Biomarkers have been introduced into clinical practice to reduce the overdiagnosis and overtreatment of low-grade PCa and increase the success of personalized therapies for high-grade and high-stage PCa. The purpose of this review was to describe available PCa biomarkers and examine their use in clinical practice. A nonsystematic literature review was performed using PubMed and Scopus to retrieve papers related to PCa biomarkers. In addition, we manually searched websites of major urological associations for PCa guidelines to evaluate available evidence and recommendations on the role of biomarkers and their potential contribution to PCa decision-making. In addition to PSA and its derivates, thirteen blood, urine, and tissue biomarkers are mentioned in various PCa guidelines. Retrospective studies have shown their utility in three main clinical scenarios: (1) deciding whether to perform a biopsy, (2) distinguishing patients who require active treatment from those who can benefit from active surveillance, and (3) defining a subset of high-risk PCa patients who can benefit from additional therapies after RP. Several validated PCa biomarkers have become commercially available in recent years. Guidelines now recommend offering these tests in situations in which the assay result, when considered in combination with routine clinical factors, is likely to affect management. However, the lack of direct comparisons and the unproven benefits, in terms of long-term survival and cost-effectiveness, prevent these biomarkers from being integrated into routine clinical use.
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Affiliation(s)
- Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy.,Division of Urology, VCU Health System, Richmond, VA, USA.,Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Zach Dovey
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - George Papastefanou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Marco Recchia
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Antonella Ninivaggi
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Pasquale Annese
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
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7
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Narain TA, Sooriakumaran P. Beyond Prostate Specific Antigen: New Prostate Cancer Screening Options. World J Mens Health 2022; 40:66-73. [PMID: 34983086 PMCID: PMC8761236 DOI: 10.5534/wjmh.210076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/06/2021] [Accepted: 07/19/2021] [Indexed: 11/15/2022] Open
Abstract
Prostate specific antigen (PSA) is one of the best-known biomarkers for screening, diagnosis and follow-up of patients for prostate cancer. Owing to several inherent limitations with PSA, various newer blood and urinary based biomarkers have been evaluated in pursuit of better detection and risk stratification of prostate cancer cases. A combination of these different markers, in adjunct with clinical risk factors, and recent advances in imaging promises to offer better diagnostic performance with clearer risk stratification guiding therapeutics. We carried out an extensive literature search for the different biomarkers available for screening and diagnosis of prostate cancer, compared their performance with serum PSA to allow clinicians to draw meaningful conclusions to offer their patients a more personalized medical care.
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Affiliation(s)
- Tushar Aditya Narain
- Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Prasanna Sooriakumaran
- Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK.,Urology Service, Cleveland Clinic London, London, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
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8
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Carlsson SV, Murata K, Danila DC, Lilja H. PSA: role in screening and monitoring patients with prostate cancer. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00001-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Rannikko A, Leht M, Mirtti T, Kenttämies A, Tolonen T, Rinta‐Kiikka I, Kilpeläinen TP, Natunen K, Lilja H, Lehtimäki T, Raitanen J, Kujala P, Ronkainen J, Matikainen M, Petas A, Taari K, Tammela T, Auvinen A. Population‐based randomized trial of screening for clinically significant prostate cancer ProScreen: pilot study. BJU Int 2021; 130:193-199. [PMID: 34958531 PMCID: PMC9327584 DOI: 10.1111/bju.15683] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate the feasibility of a population‐based screening trial using prostate‐specific antigen (PSA), a kallikrein panel and multiparametric magnetic resonance imaging (MRI) aimed at minimizing overdiagnosis, while retaining mortality benefit. Patients and Methods Feasibility of the screening algorithm was evaluated in terms of participation, screening test results and cancer detection. A random sample of 400 men aged 65 years was identified from the population registry and invited for screening with three stepwise tests (PSA, kallikrein panel and MRI). Men with PSA levels ≥3 ng/mL were further tested with the kallikrein panel, and those with positive findings (risk >7.5%) were referred for prostate MRI. Men with positive MRI (Prostate Imaging Reporting and Data System [PI‐RADS] score 3–5) had targeted biopsies only. Men with negative MRI, but PSA density ≥0.15 underwent systematic biopsies. Results Of the 399 men invited, 158 (40%) participated and 27 had PSA levels ≥3 ng/mL (7% of the invited and 17% of the participants). Of these, 22 had a positive kallikrein panel (6% of the invited and 81% of the PSA‐positive men). Finally, 10 men (3% of the invited and 45% of 4Kscore [kallikrein panel]‐positive) had a suspicious MRI finding (PI‐RADS score ≥3) and five were diagnosed with a clinically significant prostate cancer (Gleason Grade Group [GG] ≥2) at fusion biopsy (3% of the participants), with two GG 1 cases (1%). Additional testing (kallikrein panel and MRI) after PSA reduced biopsies by 56%. Conclusion The findings constitute proof of principle for our screening protocol, as we achieved a substantial detection rate for clinically significant cancer with few clinically insignificant cases. Participation, however, was suboptimal.
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Affiliation(s)
- Antti Rannikko
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
- Research Program in Systems Oncology Faculty of Medicine University of Helsinki Helsinki Finland
| | - Mare Leht
- Tampere University Faculty of Medicine and Health Technology Tampere Finland
- Helsinki and Uusimaa Hospital District Hyvinkää Hospital Department of Urology Hyvinkää Finland
| | - Tuomas Mirtti
- Research Program in Systems Oncology Faculty of Medicine University of Helsinki Helsinki Finland
- HUS Diagnostic Centre HUS Medical Imaging Centre Pathology Helsinki Finland
| | - Anu Kenttämies
- HUS Diagnostic Centre HUS Medical Imaging Centre Radiology Helsinki Finland
| | - Teemu Tolonen
- Fimlab Laboratories Department of Pathology Tampere Finland
| | - Irina Rinta‐Kiikka
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
- Tampere University Hospital Department of Radiology Tampere Finland
| | - Tuomas P. Kilpeläinen
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
- Research Program in Systems Oncology Faculty of Medicine University of Helsinki Helsinki Finland
| | - Kari Natunen
- Tampere University Faculty of Social Sciences Tampere Finland
| | - Hans Lilja
- Departments of Laboratory Medicine, Surgery, and Medicine Memorial Sloan Kettering Cancer Center New York NY USA
- Department of Translational Medicine Lund University Malmö Sweden
| | - Terho Lehtimäki
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
- Fimlab Laboratories Department of Clinical Chemistry Tampere Finland
| | - Jani Raitanen
- Tampere University Faculty of Social Sciences Tampere Finland
- UKK Institute for Health Promotion Research Tampere Finland
| | - Paula Kujala
- Fimlab Laboratories Department of Pathology Tampere Finland
| | | | - Mika Matikainen
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
| | - Anssi Petas
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
| | - Kimmo Taari
- University of Helsinki Faculty of Medicine and Helsinki University Hospital, Department of Urology Helsinki Finland
| | - Teuvo Tammela
- Tampere University Faculty of Medicine and Health Technology Tampere Finland
- Tampere University Hospital Department of Urology Tampere Finland
| | - Anssi Auvinen
- Tampere University Faculty of Social Sciences Tampere Finland
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10
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Eyrich NW, Wei JT, Niknafs YS, Siddiqui J, Ellimoottil C, Salami SS, Palapattu GS, Mehra R, Kunju LP, Tomlins SA, Chinnaiyan AM, Morgan TM, Tosoian JJ. Association of MyProstateScore (MPS) with prostate cancer grade in the radical prostatectomy specimen. Urol Oncol 2021; 40:4.e1-4.e7. [PMID: 34753659 DOI: 10.1016/j.urolonc.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 09/02/2021] [Accepted: 09/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND To evaluate the association between urinary MyProstateScore (MPS) and pathologic grade group (GG) at surgery in men diagnosed with GG1 prostate cancer (PCa) on biopsy. METHODS Using an institutional biospecimen protocol, we identified men with GG1 PCa on biopsy and PSA ≤10 ng/ml who underwent radical prostatectomy (RP) at the University of Michigan. MPS was retrospectively calculated using prospectively collected, post-DRE urine samples. The primary outcome was upgrading on RP pathology, defined as GG ≥ 2. The associations of MPS, PSA, and PSA density (PSAD) with upgrading were assessed on univariable logistic regression, and the predictive accuracy of each marker was estimated by the area under the receiver operating characteristic curve (AUC). RESULTS There were 52 men with urinary specimens available that met study criteria, based on biopsy Gleason Grade and specimen collection. At RP, 17 men (33%) had GG1 cancer and 35 (67%) had GG ≥ 2 cancer. Preoperative MPS was significantly higher in patients with GG ≥ 2 cancer at surgery (median 37.8 [IQR, 22.2-52.4]) as compared to GG1 (19.3 [IQR, 9.2-29.4]; P = 0.001). On univariable logistic regression, increasing MPS values were significantly associated with upgrading (odds ratio 1.07 per one-unit MPS increase, 95% confidence interval 1.02-1.12, P = 0.004), while PSA and PSAD were not significantly associated with upgrading. Similarly, the discriminative ability of the MPS model (AUC 0.78) for upgrading at RP was higher compared to models based on PSA (AUC 0.52) and PSAD (AUC 0.62). CONCLUSIONS In men diagnosed with GG1 PCa who underwent surgery, MPS was significantly associated with RP cancer grade. In this limited cohort of men, these findings suggest that MPS could help identify patients with undetected high-grade cancer. Additional studies are needed to better characterize this association.
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Affiliation(s)
- Nicholas W Eyrich
- Department of Urology, University of Michigan, Ann Arbor, MI; Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - John T Wei
- Department of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, University of Michigan, Ann Arbor, MI
| | - Yashar S Niknafs
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - Javed Siddiqui
- Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - Chad Ellimoottil
- Department of Urology, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Simpa S Salami
- Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Ganesh S Palapattu
- Department of Urology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Rohit Mehra
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Lakshmi P Kunju
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Scott A Tomlins
- Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Arul M Chinnaiyan
- Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Jeffrey J Tosoian
- Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI; Department of Urology, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt-Ingram Cancer Center, Nashville, TN.
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11
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Guo J, Zhang X, Xia T, Johnson H, Feng X, Simoulis A, Wu AHB, Li F, Tan W, Johnson A, Dizeyi N, Abrahamsson PA, Kenner L, Xiao K, Zhang H, Chen L, Zou C, Persson JL. Non-invasive Urine Test for Molecular Classification of Clinical Significance in Newly Diagnosed Prostate Cancer Patients. Front Med (Lausanne) 2021; 8:721554. [PMID: 34595190 PMCID: PMC8476767 DOI: 10.3389/fmed.2021.721554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/16/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: To avoid over-treatment of low-risk prostate cancer patients, it is important to identify clinically significant and insignificant cancer for treatment decision-making. However, no accurate test is currently available. Methods: To address this unmet medical need, we developed a novel gene classifier to distinguish clinically significant and insignificant cancer, which were classified based on the National Comprehensive Cancer Network risk stratification guidelines. A non-invasive urine test was developed using quantitative mRNA expression data of 24 genes in the classifier with an algorithm to stratify the clinical significance of the cancer. Two independent, multicenter, retrospective and prospective studies were conducted to assess the diagnostic performance of the 24-Gene Classifier and the current clinicopathological measures by univariate and multivariate logistic regression and discriminant analysis. In addition, assessments were performed in various Gleason grades/ISUP Grade Groups. Results: The results showed high diagnostic accuracy of the 24-Gene Classifier with an AUC of 0.917 (95% CI 0.892–0.942) in the retrospective cohort (n = 520), AUC of 0.959 (95% CI 0.935–0.983) in the prospective cohort (n = 207), and AUC of 0.930 (95% 0.912-CI 0.947) in the combination cohort (n = 727). Univariate and multivariate analysis showed that the 24-Gene Classifier was more accurate than cancer stage, Gleason score, and PSA, especially in the low/intermediate-grade/ISUP Grade Group 1–3 cancer subgroups. Conclusions: The 24-Gene Classifier urine test is an accurate and non-invasive liquid biopsy method for identifying clinically significant prostate cancer in newly diagnosed cancer patients. It has the potential to improve prostate cancer treatment decisions and active surveillance.
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Affiliation(s)
- Jinan Guo
- Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.,Shenzhen Urology Minimally Invasive Engineering Center, Shenzhen, China.,Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, Clinical Medicine Research Centre, Shenzhen, China
| | - Xuhui Zhang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, Beijing, China
| | - Taolin Xia
- Department of Urology, Foshan First People's Hospital, Foshan, China
| | | | - Xiaoyan Feng
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, Beijing, China
| | - Athanasios Simoulis
- Department of Clinical Pathology and Cytology, Skåne University Hospital, Malmö, Sweden
| | - Alan H B Wu
- Clinical Laboratories, San Francisco General Hospital, San Francisco, CA, United States
| | - Fei Li
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wanlong Tan
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | - Nishtman Dizeyi
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Per-Anders Abrahamsson
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Lukas Kenner
- Department of Experimental Pathology, Medical University Vienna & Unit of Laboratory Animal Pathology, University of Veterinary Medicine, Vienna, Austria
| | - Kefeng Xiao
- Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.,Shenzhen Urology Minimally Invasive Engineering Center, Shenzhen, China.,Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, Clinical Medicine Research Centre, Shenzhen, China
| | - Heqiu Zhang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, Beijing, China
| | - Lingwu Chen
- Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chang Zou
- Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.,Shenzhen Urology Minimally Invasive Engineering Center, Shenzhen, China.,Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, Clinical Medicine Research Centre, Shenzhen, China.,Key Laboratory of Medical Electrophysiology of Education Ministry, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jenny L Persson
- Department of Molecular Biology, Umeå University, Umeå, Sweden.,Department of Biomedical Sciences, Malmö University, Malmö, Sweden.,Division of Experimental Cancer Research, Department of Translational Medicine, Lund University, Malmö, Sweden
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12
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Balázs K, Antal L, Sáfrány G, Lumniczky K. Blood-Derived Biomarkers of Diagnosis, Prognosis and Therapy Response in Prostate Cancer Patients. J Pers Med 2021; 11:296. [PMID: 33924671 PMCID: PMC8070149 DOI: 10.3390/jpm11040296] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/31/2021] [Accepted: 04/03/2021] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer is among the most frequent cancers in men worldwide. Despite the fact that multiple therapeutic alternatives are available for its treatment, it is often discovered in an advanced stage as a metastatic disease. Prostate cancer screening is based on physical examination of prostate size and prostate-specific antigen (PSA) level in the blood as well as biopsy in suspect cases. However, these markers often fail to correctly identify the presence of cancer, or their positivity might lead to overdiagnosis and consequent overtreatment of an otherwise silent non-progressing disease. Moreover, these markers have very limited if any predictive value regarding therapy response or individual risk for therapy-related toxicities. Therefore, novel, optimally liquid biopsy-based (blood-derived) markers or marker panels are needed, which have better prognostic and predictive value than the ones currently used in the everyday routine. In this review the role of circulating tumour cells, extracellular vesicles and their microRNA content, as well as cellular and soluble immunological and inflammation- related blood markers for prostate cancer diagnosis, prognosis and prediction of therapy response is discussed. A special emphasis is placed on markers predicting response to radiotherapy and radiotherapy-related late side effects.
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Affiliation(s)
| | | | | | - Katalin Lumniczky
- Unit of Radiation Medicine, Department of Radiobiology and Radiohygiene, National Public Health Centre, 1221 Budapest, Hungary; (K.B.); (L.A.); (G.S.)
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13
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4Kscore diagnostic value in patients with high-grade prostate cancer using cutoff values of 7.5% to 10%: A meta-analysis. Urol Oncol 2021; 39:366.e1-366.e10. [PMID: 33685800 DOI: 10.1016/j.urolonc.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/24/2020] [Accepted: 11/01/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Reported 4Kscore thresholds used to differentiate between patients with and without high-grade prostate cancer (CaP) were variable. Patients with 4Kscore results <7.5% have been proven to be at low risk of carrying high-grade CaP. This study employed a meta-analysis approach in order to assess the diagnostic accuracy of the 4Kscore as a means of detecting high-grade CaP in prostate biopsy samples using cutoff values of 7.5% to 10%. METHODS Relevant studies published as of December 2019 were identified via searching PubMed, Embase, and Cochrane Library. Data pertaining to 4Kscore diagnostic accuracy were then extracted from these studies and utilized for the calculation of pooled sensitivity , specificity , diagnostic odds ratio , and area under the curve values relating to high-grade CaP diagnosis. RESULTS In total, 9 studies incorporating 1,689 high-grade CaP patients were included in our meta-analysis. Following the exclusion of 1 outlier study, the pooled sensitivity, specificity , diagnostic odds ratio , and area under the curve values for 4Kscore diagnostic accuracy with corresponding 95% confidence intervals (CIs) were 0.90 (95%CI: 0.86-0.92), 0.44 (95%CI: 0.36-0.52), 7 (95%CI: 5-8), and 0.81 (95%CI: 0.77-0.84), respectively. CONCLUSION These findings indicate that 4Kscore can be used as a model for the diagnosis of high-grade CaP. However, we detected significant heterogeneity among studies that was not explained by subgroup or meta-regression analysis, thus lowering our confidence in these results. It is therefore essential that future large, well-designed studies be conducted so as to confirm whether the 4Kscore can be used with cutoff values of 7.5% to 10% to reliably detect high-grade CaP.
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14
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Nasser NJ, Klein J, Agbarya A. Markers of Toxicity and Response to Radiation Therapy in Patients With Prostate Cancer. Adv Radiat Oncol 2021; 6:100603. [PMID: 33490732 PMCID: PMC7811126 DOI: 10.1016/j.adro.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 02/07/2023] Open
Abstract
The main treatment modalities for localized prostate cancer are surgery and radiation. Surgery removes the whole prostate gland, whereas with radiation therapy the irradiated prostate remains within the patient's body. Biomarkers specific to the prostate gland should become undetectable after surgery, but this is not the case when radiation therapy is used, as residual prostate cells may still be metabolically active. Here, we review the role of tumor markers of toxicity and response to radiation therapy in patients with prostate cancer, including prostate specific antigen, human kallikrein 2, osteopontin, prostate cancer associated 3, citrulline, and others.
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Affiliation(s)
- Nicola J. Nasser
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan Klein
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Abed Agbarya
- Institute of Oncology, Bnai Zion Medical Center, Haifa, Israel
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15
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Haese A, Tin AL, Carlsson SV, Sjoberg DD, Pehrke D, Steuber T, Huland H, Graefen M, Scardino PT, Schlomm T, Vickers AJ, Lilja H, Sauter G. A pre-specified model based on four kallikrein markers in blood improves predictions of adverse pathology and biochemical recurrence after radical prostatectomy. Br J Cancer 2020; 123:604-609. [PMID: 32467601 PMCID: PMC7434907 DOI: 10.1038/s41416-020-0914-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/17/2020] [Accepted: 05/06/2020] [Indexed: 01/01/2023] Open
Abstract
Background A pre-specified model based on four kallikrein markers in blood, commercially available as 4Kscore, predicts Gleason Grade (GG) 3 + 4 or higher prostate cancer on biopsy. However, sampling error and variation in pathology reporting may miss aggressive disease. Methods The 4Kscore was measured in cryopreserved blood from 2330 men obtained before prostatectomy at a single institution between 2002 and 2010. Adverse surgical pathology and biochemical recurrence (BCR) were pre-specified to be assessed in all men, biopsy GG 3 + 3, and 3 + 4. Results Adjusted for established clinical predictors, the 4Kscore was significantly associated with adverse pathology (OR 1.49; 95% CI 1.32, 1.67; p < 0.0001). Adding 4Kscore increased discrimination from (AUC) 0.672 to 0.718 and 0.644 to 0.659 within biopsy GG 3 + 3 and 3 + 4, respectively. Higher 4Kscore was associated with higher risk of BCR (HR 1.16, 95% CI 1.06, 1.26; p = 0.001). Adding 4Kscore improved the prediction of BCR (C-index 0.630–0.660) within GG 3 + 3, but not GG 3 + 4. Conclusions The 4Kscore can help guide the clinical decision whether additional risk assessment—such as confirmatory biopsy—is needed to decide between active surveillance versus curative therapy. Evidence that the panel could influence management in biopsy GG 3 + 4 is less strong and requires further investigation.
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Affiliation(s)
- Alexander Haese
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amy L Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sigrid V Carlsson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel D Sjoberg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dirk Pehrke
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Steuber
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hartwig Huland
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter T Scardino
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thorsten Schlomm
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andrew J Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hans Lilja
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Departments of Laboratory Medicine and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. .,Department of Translational Medicine, Lund University, Malmö, Sweden.
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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16
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Jin W, Fei X, Wang X, Song Y, Chen F. Detection and Prognosis of Prostate Cancer Using Blood-Based Biomarkers. Mediators Inflamm 2020; 2020:8730608. [PMID: 32454797 PMCID: PMC7218965 DOI: 10.1155/2020/8730608] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/24/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022] Open
Abstract
Prostate cancer (PCa) is second only to lung cancer as a cause of death. Clinical assessment of patients and treatment efficiency therefore depend on the disease being diagnosed as early as possible. However, due to issues regarding the use of prostate-specific antigen (PSA) for screening purposes, PCa management is among the most contentious of healthcare matters. PSA screening is problematic primarily because of diagnosis difficulties and the high rate of false-positive biopsies. Novel PCa biomarkers, such as the Prostate Health Index (PHI) and the 4Kscore, have been proposed in recent times to improve PSA prediction accuracy and have shown higher performance by preventing redundant biopsies. The 4Kscore also shows high precision in determining the risk of developing high-grade PCa, whereas elevated PHI levels suggest that the tumor is aggressive. Some evidence also supports the effectiveness of miRNAs as biomarkers for distinguishing PCa from benign prostatic hyperplasia and for assessing the aggressiveness of the disease. A number of miRNAs that possibly act as tumor inhibitors or oncogenes are impaired in PCa. These new biomarkers are comprehensively reviewed in the present study in terms of their potential use in diagnosing and treating PCa.
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Affiliation(s)
- Wei Jin
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiang Fei
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xia Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan Song
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fangjie Chen
- Department of Medical Genetics, School of Life Sciences, China Medical University, Shenyang, Liaoning, China
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17
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A predictive model for prostate cancer incorporating PSA molecular forms and age. Sci Rep 2020; 10:2463. [PMID: 32051423 PMCID: PMC7016114 DOI: 10.1038/s41598-020-58836-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
The diagnostic specificity of prostate specific antigen (PSA) is limited. We aimed to characterize eight anti-PSA monoclonal antibodies (mAbs) to assess the prostate cancer (PCa) diagnostic utility of different PSA molecular forms, total (t) and free (f) PSA and PSA complexed to α1-antichymotrypsin (complexed PSA). MAbs were obtained by immunization with PSA and characterized by competition studies, ELISAs and immunoblotting. With them, we developed sensitive and specific ELISAs for these PSA molecular forms and measured them in 301 PCa patients and 764 patients with benign prostate hyperplasia, and analyzed their effectiveness to discriminate both groups using ROC curves. The free-to-total (FPR) and the complexed-to-total PSA (CPR) ratios significantly increased the diagnostic yield of tPSA. Moreover, based on model selection, we constructed a multivariable logistic regression model to predictive PCa that includes tPSA, fPSA, and age as predictors, which reached an optimism-corrected area under the ROC curve (AUC) of 0.86. Our model outperforms the predictive ability of tPSA (AUC 0.71), used in clinical practice. In conclusion, The FPR and CPR showed better diagnostic yield than tPSA. In addition, the PCa predictive model including age, fPSA and complexed PSA, outperformed tPSA detection efficacy. Our model may avoid unnecessary biopsies, preventing harmful side effects and reducing health expenses.
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18
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Kiebish MA, Cullen J, Mishra P, Ali A, Milliman E, Rodrigues LO, Chen EY, Tolstikov V, Zhang L, Panagopoulos K, Shah P, Chen Y, Petrovics G, Rosner IL, Sesterhenn IA, McLeod DG, Granger E, Sarangarajan R, Akmaev V, Srinivasan A, Srivastava S, Narain NR, Dobi A. Multi-omic serum biomarkers for prognosis of disease progression in prostate cancer. J Transl Med 2020; 18:10. [PMID: 31910880 PMCID: PMC6945688 DOI: 10.1186/s12967-019-02185-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/23/2019] [Indexed: 01/31/2023] Open
Abstract
Background Predicting the clinical course of prostate cancer is challenging due to the wide biological spectrum of the disease. The objective of our study was to identify prostate cancer prognostic markers in patients ‘sera using a multi-omics discovery platform. Methods Pre-surgical serum samples collected from a longitudinal, racially diverse, prostate cancer patient cohort (N = 382) were examined. Linear Regression and Bayesian computational approaches integrated with multi-omics, were used to select markers to predict biochemical recurrence (BCR). BCR-free survival was modeled using unadjusted Kaplan–Meier estimation curves and multivariable Cox proportional hazards analysis, adjusted for key pathologic variables. Receiver operating characteristic (ROC) curve statistics were used to examine the predictive value of markers in discriminating BCR events from non-events. The findings were further validated by creating a training set (N = 267) and testing set (N = 115) from the cohort. Results Among 382 patients, 72 (19%) experienced a BCR event in a median follow-up time of 6.9 years. Two proteins—Tenascin C (TNC) and Apolipoprotein A1V (Apo-AIV), one metabolite—1-Methyladenosine (1-MA) and one phospholipid molecular species phosphatidic acid (PA) 18:0-22:0 showed a cumulative predictive performance of AUC = 0.78 [OR (95% CI) = 6.56 (2.98–14.40), P < 0.05], in differentiating patients with and without BCR event. In the validation set all four metabolites consistently reproduced an equivalent performance with high negative predictive value (NPV; > 80%) for BCR. The combination of pTstage and Gleason score with the analytes, further increased the sensitivity [AUC = 0.89, 95% (CI) = 4.45–32.05, P < 0.05], with an increased NPV (0.96) and OR (12.4) for BCR. The panel of markers combined with the pathological parameters demonstrated a more accurate prediction of BCR than the pathological parameters alone in prostate cancer. Conclusions In this study, a panel of serum analytes were identified that complemented pathologic patient features in predicting prostate cancer progression. This panel offers a new opportunity to complement current prognostic markers and to monitor the potential impact of primary treatment versus surveillance on patient oncological outcome.
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Affiliation(s)
| | - Jennifer Cullen
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Prachi Mishra
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Amina Ali
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | | | | | | | | | | | | | - Yongmei Chen
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Gyorgy Petrovics
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Inger L Rosner
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - David G McLeod
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | | | | | - Alagarsamy Srinivasan
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Shiv Srivastava
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Albert Dobi
- Henry Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. .,Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD, USA.
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19
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Anceschi U, Tuderti G, Lugnani F, Biava PM, Malossini G, Luciani L, Cai T, Marsiliani D, Filianoti A, Mattevi D, Costantini M, Misuraca L, Simone G. Novel Diagnostic Biomarkers of Prostate Cancer: An Update. Curr Med Chem 2019; 26:1045-1058. [PMID: 30215331 DOI: 10.2174/0929867325666180914115416] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/27/2018] [Accepted: 07/11/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE In recent years, several biomarkers alternative to standard prostate specific antigen (PSA) for prostate cancer (PCa) diagnosis have become available. The aim of this systematic review is to assess the current knowledge about alternative serum and urinary biomarkers for the diagnosis of PCa. MATERIAL AND METHODS A research was conducted in Medline, restricted to English language articles published between December 2014 and June 2018 with the aim to update previously published series on PCa biomarkers. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria were used for selecting studies with the lowest risk of bias. RESULTS Emerging role and actual controversies on serum and urine alternative biomarkers to standard PSA for PCa diagnosis, staging and prognosis assessment, such as prostate health index (PHI), PCA3, ConfirmMDx, Aberrant PSA glycosylation, MiPS, miRNAs are critically presented in the current review. CONCLUSION Although the use of several biomarkers has been recommended or questioned by different international guidelines, larger prospective randomized studies are still necessary to validate their efficacy in PCa detection, discrimination, prognosis and treatment effectiveness. To date, only PHI and 4Kscore have shown clinical relevance for discriminating more aggressive PCa. Furthermore, a new grading classification based on molecular features relevant for PCa risk-stratification and tailoring treatment is still needed.
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Affiliation(s)
- Umberto Anceschi
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Gabriele Tuderti
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | | | - Pier Mario Biava
- Scientific Institute of Research and Care Multimedica, Milan, Italy
| | - Gianni Malossini
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Lorenzo Luciani
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Davide Marsiliani
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | | | - Daniele Mattevi
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Manuela Costantini
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Leonardo Misuraca
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Giuseppe Simone
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
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A Rich Array of Prostate Cancer Molecular Biomarkers: Opportunities and Challenges. Int J Mol Sci 2019; 20:ijms20081813. [PMID: 31013716 PMCID: PMC6515282 DOI: 10.3390/ijms20081813] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 01/30/2023] Open
Abstract
Prostate cancer is the most prevalent non-skin cancer in men and is the leading cause of cancer-related death. Early detection of prostate cancer is largely determined by a widely used prostate specific antigen (PSA) blood test and biopsy is performed for definitive diagnosis. Prostate cancer is asymptomatic in the early stage of the disease, comprises of diverse clinico-pathologic and progression features, and is characterized by a large subset of the indolent cancer type. Therefore, it is critical to develop an individualized approach for early detection, disease stratification (indolent vs. aggressive), and prediction of treatment response for prostate cancer. There has been remarkable progress in prostate cancer biomarker discovery, largely through advancements in genomic technologies. A rich array of prostate cancer diagnostic and prognostic tests has emerged for serum (4K, phi), urine (Progensa, T2-ERG, ExoDx, SelectMDx), and tumor tissue (ConfirmMDx, Prolaris, Oncoytype DX, Decipher). The development of these assays has created new opportunities for improving prostate cancer diagnosis, prognosis, and treatment decisions. While opening exciting opportunities, these developments also pose unique challenges in terms of selecting and incorporating these assays into the continuum of prostate cancer patient care.
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21
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Verbeek JF, Bangma CH, Kweldam CF, van der Kwast TH, Kümmerlin IP, van Leenders GJ, Roobol MJ. Reducing unnecessary biopsies while detecting clinically significant prostate cancer including cribriform growth with the ERSPC Rotterdam risk calculator and 4Kscore. Urol Oncol 2019; 37:138-144. [DOI: 10.1016/j.urolonc.2018.11.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/15/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
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22
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Lamy PJ, Allory Y, Gauchez AS, Asselain B, Beuzeboc P, de Cremoux P, Fontugne J, Georges A, Hennequin C, Lehmann-Che J, Massard C, Millet I, Murez T, Schlageter MH, Rouvière O, Kassab-Chahmi D, Rozet F, Descotes JL, Rébillard X. Prognostic Biomarkers Used for Localised Prostate Cancer Management: A Systematic Review. Eur Urol Focus 2018; 4:790-803. [DOI: 10.1016/j.euf.2017.02.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/08/2017] [Accepted: 02/24/2017] [Indexed: 11/28/2022]
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Jalón Monzón A, Alvarez Múgica M, Jalón Monzón M, Escaf Barmadah S. [What primary care physicians should know about new markers in prostate cancer]. Semergen 2018; 44:430-438. [PMID: 30049576 DOI: 10.1016/j.semerg.2017.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/14/2017] [Accepted: 12/14/2017] [Indexed: 11/16/2022]
Abstract
The use of prostate-specific antigen as a diagnostic tool in the screening of prostate cancer is reflected in an increase in the incidence, an increase in diagnosis at initial stages, and an increase in radical therapies, even at the expense of over-treatment in some cases. It is known from the data collected in the literature that not every patient with high prostate-specific antigen needs a biopsy, and that not every patient diagnosed with prostate cancer needs treatment. With the new emerging prostate markers, we will try to improve the specificity of prostate-specific antigen in the grey area (4-10 ng/ml) should be improved. This should avoid unnecessary biopsies. The sensitivity in the detection of significant prostate cancer with low prostate-specific antigen should also be improved in an attempt to reduce the risk of over-treatment. On the other hand, prognostic biomarkers with genomic tests will help to choose the best therapeutic option for the patient.
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Affiliation(s)
- A Jalón Monzón
- Servicio de Urología, Hospital Universitario Central de Asturias (HUCA), Oviedo (Asturias), España.
| | - M Alvarez Múgica
- Servicio de Urología, Hospital Valle del Nalón, Langreo (Asturias), España
| | | | - S Escaf Barmadah
- Servicio de Urología, Hospital Universitario Central de Asturias (HUCA), Oviedo (Asturias), España
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Maccini MA, Westfall NJ, Van Bokhoven A, Lucia MS, Poage W, Maroni PD, Wilson SS, Glodé LM, Arangua P, Newmark J, Steiner M, Werahera PN, Crawford ED. The effect of digital rectal exam on the 4Kscore for aggressive prostate cancer. Prostate 2018; 78:506-511. [PMID: 29460452 PMCID: PMC6237549 DOI: 10.1002/pros.23495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/22/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The 4Kscore is a new commercially available blood-based diagnostic test which predicts risk for aggressive, clinically significant prostate cancer on prostate biopsy. The 4Kscore is currently restricted to patients who have not had a digital rectal exam (DRE) in the previous 96 h, owing to prior mixed data suggesting that prostate specific antigen (PSA) isoforms may increase by a statistically significant-if not necessarily clinically significant-amount shortly after DRE. Our primary objective was to determine if 4Kscore test results are affected by a preceding DRE. METHODS Participants at a Prostate Cancer Awareness Week screening event sponsored by the Prostate Conditions Education Council filled out clinical history questionnaires and had blood samples for 4Kscore testing drawn prior to DRE, then 15-45 min following DRE. Patients with prior cancer diagnosis, 5-alpha reductase inhibitor medication use, or lower urinary tract procedures in the prior 6 months were excluded, resulting in a population of 162 participants for analysis. Values were then compared to determine if there was a significant difference in 4Kscore following DRE. RESULTS A statistically significant increase was seen in levels of 3 kallikreins measured (total PSA, free PSA, and intact PSA; median <0.03 ng/mL for all). This resulted in a small but statistically significant decrease in post-DRE 4Kscore (median absolute score decrease 0.43%). Using a 4Kscore cutoff of 7.5% resulted in reclassification of 10 patients (6.2%), nine of whom were "downgraded" from above the cutoff to below. CONCLUSIONS If the blood draw for the 4 K score is performed after a screening DRE, there is a statistically significant difference in the 4 K score results, but in the vast majority of cases it would not affect clinical decision making.
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Affiliation(s)
| | | | | | - M. Scott Lucia
- University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Wendy Poage
- Prostate Condition Education Council, Aurora, CO
| | - Paul D Maroni
- University of Colorado, Anschutz Medical Campus, Aurora, CO
| | | | | | - Paul Arangua
- University of Colorado, Anschutz Medical Campus, Aurora, CO
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Abstract
Diagnostic biomarkers derived from blood, urine, or prostate tissue provide additional information beyond clinical calculators to determine the risk of detecting high-grade prostate cancer. Once diagnosed, multiple markers leverage prostate cancer biopsy tissue to prognosticate clinical outcomes, including adverse pathology at radical prostatectomy, disease recurrence, and prostate cancer mortality; however the clinical utility of some outcomes to patient decision making is unclear. Markers using tissue from radical prostatectomy specimens provide additional information about the risk of biochemical recurrence, development of metastatic disease, and subsequent mortality beyond existing multivariable clinical calculators (the use of a marker to simply sub-stratify risk groups such as the NCCN groups is of minimal value). No biomarkers currently available for prostate cancer have been prospectively validated to be predict an improved clinical outcome for a specific therapy based on the test result; however, further research and development of these tests may produce a truly predictive biomarker for prostate cancer treatment.
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Affiliation(s)
- Adam J Gadzinski
- Department of Urology, University of California-San Francisco, San Francisco, CA, USA
| | - Matthew R Cooperberg
- Department of Urology, University of California-San Francisco, San Francisco, CA, USA.
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Evaluation and Treatment for Older Men with Elevated PSA. Prostate Cancer 2018. [DOI: 10.1007/978-3-319-78646-9_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Loeb S, Dani H. Whom to Biopsy: Prediagnostic Risk Stratification with Biomarkers, Nomograms, and Risk Calculators. Urol Clin North Am 2017; 44:517-524. [PMID: 29107268 PMCID: PMC6004126 DOI: 10.1016/j.ucl.2017.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes markers used for prostate biopsy decisions, including prostrate-specific antigen (PSA), free PSA, the prostate health index, 4Kscore, PCA3, and ConfirmMDx. It also summarizes the use of nomograms combining multiple variables for prostate cancer detection.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University, New York, NY, USA; Department of Population Health, New York University, New York, NY, USA; Department of Urology, Manhattan Veterans Affairs Medical Center, New York, NY, USA.
| | - Hasan Dani
- Department of Urology, SUNY Downstate College of Medicine, Brooklyn, NY, USA
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28
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Human tissue Kallikreins: Blood levels and response to radiotherapy in intermediate risk prostate cancer. Radiother Oncol 2017; 124:427-432. [DOI: 10.1016/j.radonc.2017.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 11/17/2022]
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A Systematic Review and Meta-analysis of the Diagnostic Accuracy of Prostate Health Index and 4-Kallikrein Panel Score in Predicting Overall and High-grade Prostate Cancer. Clin Genitourin Cancer 2017; 15:429-439.e1. [DOI: 10.1016/j.clgc.2016.12.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/14/2016] [Accepted: 12/22/2016] [Indexed: 01/01/2023]
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A randomized trial of early detection of clinically significant prostate cancer (ProScreen): study design and rationale. Eur J Epidemiol 2017; 32:521-527. [PMID: 28762124 DOI: 10.1007/s10654-017-0292-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/27/2017] [Indexed: 12/11/2022]
Abstract
The current evidence of PSA-based prostate cancer screening shows a reduction in cause-specific mortality, but with substantial overdiagnosis. Recently, new developments in detection of clinically relevant prostate cancer include multiple kallikreins as biomarkers besides PSA, and multiparametric magnetic resonance imaging (mpMRI) for biopsy decision. They offer opportunities for improving the outcomes in screening, particularly reduction in overdiagnosis and higher specificity for potentially lethal cancer. A population-based randomized screening trial will be started, with 67,000 men aged 55-67 years at entry. A quarter of the men will be allocated to the intervention arm, and invited to screening. The control arm will receive no intervention. All men in the screening arm will be offered a serum PSA determination. Those with PSA of 3 ng/ml or higher will have an additional multi-kallikrein panel and those with indications of increased risk of clinically relevant prostate cancer will undergo mpMRI. Men with a malignancy-suspect finding in MRI are referred to targeted biopsies. Screening interval is 6 years for men with baseline PSA < 1.5 ng/ml, 4 years with PSA 1.5-3.0 and 2 years if initial PSA > 3. The main outcome of the trial is prostate cancer mortality, with analysis at 10 and 15 years. The statistical power is sufficient for detecting a 28% reduction at 10 years and 22% at 15 years. The proposed study has the potential to provide the evidence to justify screening as a public health policy if mortality benefit can be sustained with substantially reduced overdiagnosis.
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31
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Ploussard G. Kallikreins Panel for Prostate Cancer Aggressiveness Prediction: More Is Not Enough. Eur Urol Focus 2017; 3:100-101. [PMID: 28720353 DOI: 10.1016/j.euf.2016.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
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32
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Loeb S. Biomarkers for Prostate Biopsy and Risk Stratification of Newly Diagnosed Prostate Cancer Patients. UROLOGY PRACTICE 2017; 4:315-321. [PMID: 29104903 PMCID: PMC5667651 DOI: 10.1016/j.urpr.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Many new markers are now available as an aid for decisions about prostate biopsy for men without prostate cancer, and/or to improve risk stratification for men with newly diagnosed prostate cancer. METHODS A literature review was performed on currently available markers for use in decisions about prostate biopsy and initial prostate cancer treatment. RESULTS Although total prostate-specific antigen cutoffs were traditionally used for biopsy decisions, PSA elevations are not specific. Repeating the PSA test, and adjusting for factors like age, prostate volume and changes over time can increase specificity for biopsy decisions. The Prostate Health Index (phi) and 4K Score are new PSA-based markers that can be offered as second-line tests to decide on initial or repeat prostate biopsy. The PCA3 urine test and ConfirmMDx tissue test are additional options for repeat biopsy decisions. For men with newly diagnosed prostate cancer, genomic tests are available to refine risk classification and may influence treatment decisions. CONCLUSIONS Numerous secondary testing options are now available that can be offered to patients deciding whether to undergo prostate biopsy and those with newly diagnosed prostate cancer.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, Population Health, and the Laura & Isaac Perlmutter Cancer Center, New York University and the Manhattan Veterans Affairs Medical Center, NY, USA
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33
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Zappala SM, Dong Y, Linder V, Reeve M, Sjoberg DD, Mathur V, Roberts R, Okrongly D, Newmark J, Sant G, Steiner M. The 4Kscore blood test accurately identifies men with aggressive prostate cancer prior to prostate biopsy with or without DRE information. Int J Clin Pract 2017; 71. [PMID: 28497893 DOI: 10.1111/ijcp.12943] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/26/2017] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The 4Kscore Test is a prebiopsy blood test that incorporates four prostate protein biomarkers along with patient clinical information to determine a man's risk for high-grade, aggressive (Gleason ≥7) prostate cancer. However, some men likely to benefit from the test may be seen in primary care settings where the digital rectal examination (DRE) information is not always obtained. In this study, we assessed the clinical validity of the 4Kscore Test when the DRE information was not included in the algorithm. METHODS The Prospective 4Kscore Validation Study enrolled 1012 men scheduled for prostate biopsy across 26 urology practices in the United States. The 4Kscore was calculated for each patient with and without DRE information. The primary outcome was Gleason ≥7 prostate cancer on prostate biopsy. The contribution of DRE to the predictive accuracy of the test was evaluated by area under the receiver operating curve (AUC-ROC), risk calibration and clinical consequences. RESULTS High-grade, aggressive prostate cancer was found in 231 (23%) of the 1012 patients. Both versions of the 4Kscore Test, with and without DRE, showed excellent discrimination (AUC=0.821 with DRE and AUC=0.818 without DRE input) and excellent calibration. No clinically significant difference was found between the two versions of the 4Kscore. CONCLUSIONS The 4Kscore Test algorithm, whether DRE findings are available or not, performs well in predicting a man's risk of high-grade, aggressive prostate cancer. Patients who are suspected of having aggressive prostate cancer can safely have their risk better defined by 4Kscore even if a DRE has not been performed recently.
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Affiliation(s)
| | - Yan Dong
- OPKO Diagnostics, Woburn, MA, USA
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Abstract
PURPOSE OF REVIEW This article intends to review biomarkers derived from blood, urine, and tissue that can aid in the diagnosis of prostate cancer (PCa). RECENT FINDINGS PCa screening requires tools that complement prostate-specific antigen (PSA) with a higher specificity for clinically significant disease. Novel blood biomarkers, such as the Prostate Health Index (phi) and 4Kscore, utilize isoforms of PSA to more accurately predict high-grade PCa than traditional tools such as PSA and the percentage free-to-total PSA. Several gene products associated with PCa can be detected in the urine through commercially available assays. PCa antigen 3 (PCA3), though approved for repeat biopsy decisions, appears inferior to other biomarkers such as phi for identifying aggressive disease. However, combinations of PCA3 with other urine assays have shown promising results. One tissue-based hypermethylation test, named ConfirmMDx, can also be used to determine the need for repeat biopsy in men with a prior negative biopsy. SUMMARY Several biomarkers have been developed to aid in the screening and diagnosis of PCa. Such tests are often indicated in men with moderately elevated PSA or history of a prior negative biopsy. Their use facilitates reduction of unnecessary biopsies without sacrificing the early diagnosis of clinically significant PCa.
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Affiliation(s)
- Hasan Dani
- Department of Urology, SUNY Downstate College of Medicine, Brooklyn, NY
| | - Stacy Loeb
- Department of Urology, New York University, NY, NY
- Population Health, New York University, NY, NY
- Manhattan Veterans Affairs Medical Center, NY, NY
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35
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Diamandis EP. Significant increase of serum prostate-specific antigen after exercise. Clin Chem Lab Med 2017; 54:e245-6. [PMID: 26910748 DOI: 10.1515/cclm-2016-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/11/2016] [Indexed: 11/15/2022]
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36
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Punnen S, Nahar B, Prakash NS, Sjoberg DD, Zappala SM, Parekh DJ. The 4Kscore Predicts the Grade and Stage of Prostate Cancer in the Radical Prostatectomy Specimen: Results from a Multi-institutional Prospective Trial. Eur Urol Focus 2017; 3:94-99. [DOI: 10.1016/j.euf.2015.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 11/25/2015] [Accepted: 12/11/2015] [Indexed: 01/22/2023]
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Screening and Detection of Prostate Cancer-Review of Literature and Current Perspective. Indian J Surg Oncol 2017; 8:160-168. [PMID: 28546712 DOI: 10.1007/s13193-016-0584-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022] Open
Abstract
Screening of prostatic cancer is a matter of debate among uro-oncologist. With many new screening modalities like prostatic health index (PHI), 4K testing the role of screening has increased as one is able to stratify patients with serum prostate specific antigen level in a grey zone of 4-10 ng/ml and normal digital rectal examination into various risk groups, thus avoiding unnecessary biopsy which was the pitfalls of routine screening practice. PHI is better at predicting malignancy while 4K is better at predicting high-grade disease. This in combination with multiparametric MRI especially with prostate imaging reporting and data system score has made screening less difficult and more meaningful for a practising uro-oncologist.
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Abstract
A new generation of prostate cancer (PCa) biomarkers has emerged, including diagnostic serum and urine markers aimed at refining the identification high-grade tumors and tissue-based gene expression assays offering prognostic and predictive clinical information. Such tests seek to improve treatment-related decisions at multiple decision points, including initial diagnosis and following initial primary therapy. In this review, we aim to contextualize the body of evidence surrounding these emerging tests, with attention on studies addressing clinical utility.
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Ahmad AS, Vasiljević N, Carter P, Berney DM, Møller H, Foster CS, Cuzick J, Lorincz AT. A novel DNA methylation score accurately predicts death from prostate cancer in men with low to intermediate clinical risk factors. Oncotarget 2016; 7:71833-71840. [PMID: 27708246 PMCID: PMC5342126 DOI: 10.18632/oncotarget.12377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/20/2016] [Indexed: 01/01/2023] Open
Abstract
Clinically aggressive disease behavior is difficult to predict in men with low to intermediate clinical risk prostate cancer and methylation biomarkers may be a valuable adjunct for assessing the management of these patients. We set to evaluate the utility of DNA methylation to identify high risk disease in men currently considered as low or intermediate risk. DNA was extracted from formalin-fixed paraffin-embedded transurethral prostate resection tissues collected during the years 1990-96 in a watchful-waiting cohort of men in the UK. The primary end point was death of prostate cancer, assessed by reviewing cancer registry records from 2009. Methylation was quantified by pyrosequencing assays for six genes (HSPB1, CCND2, TIG1, DPYS, PITX2, and MAL) with established biomarker value in prostate cancer. A novel prognostic methylation score was developed by multivariate Cox modelling using the six methylation biomarkers in 385 men with low-and-intermediate clinical risk variables and its prognostic value compared to two previously defined clinically-derived risk scores. Methylation score was the most significant variable in univariate and bivariate analysis in men with low-to-intermediate CAPRA risk score. When combined with CAPRA score the hazard ratio was 2.02; 95% confidence interval, 1.40-2.92. For a methylation score sensitivity of 83% the specificity was 44%, while the maximum achieved sensitivity by CAPRA was 68% at a specificity of 44%. The derived methylation score is a strong predictor of aggressive prostate cancer that could have an important role in directing the management of patients with low-to-intermediate risk disease. The estimated areas under the curve (AUC) at 10 years of follow-up were 0.62 (95% CI: 0.51, 0.70) and 0.74 (95% CI: 0.65, 0.82) for CAPRA, and combined (CAPRA + methylation) risk score (CRS) respectively.
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Affiliation(s)
- Amar S. Ahmad
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Nataša Vasiljević
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Paul Carter
- Centre for Molecular Pathology, Royal Marsden Hospital, Sutton, SM2 5PT, UK
| | - Daniel M Berney
- Molecular Oncology Centre, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Henrik Møller
- King's College London, Cancer Epidemiology and Population Global Health Program, London, SE1 3QD, UK
| | | | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Attila T. Lorincz
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, EC1M 6BQ, UK
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Kim EH, Andriole GL, Crawford ED, Sjoberg DD, Assel M, Vickers AJ, Lilja H. Detection of High Grade Prostate Cancer among PLCO Participants Using a Prespecified 4-Kallikrein Marker Panel. J Urol 2016; 197:1041-1047. [PMID: 27810449 DOI: 10.1016/j.juro.2016.10.089] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE We assessed the performance of a 4-kallikrein panel with and without microseminoprotein-β to predict high grade (Gleason 7+/Gleason Grade Group 2+) prostate cancer on biopsy in a multiethnic cohort from PLCO (Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial). MATERIALS AND METHODS Levels of free, intact, total prostate specific antigen, human kallikrein-2 and microseminoprotein-β were measured while blinded to outcomes in cryopreserved serum from men in the intervention arm of PLCO. Marker levels of 946 men, of whom 100 were African American, were incorporated into a prespecified statistical model to predict high grade prostate cancer on biopsy. RESULTS The detection of high grade prostate cancer in 94 men (10%) was enhanced by the 4-kallikrein panel with an AUC of 0.79 compared to 0.73 for PCPTRC (Prostate Cancer Prevention Trial Risk Calculator), representing a 0.060 increase (95% CI 0.032-0.088, p <0.01). Additionally, the AUC increased from 0.79 to 0.81 when microseminoprotein-β was added to the 4-kallikrein panel. In African American men, the 4-kallikrein panel model also enhanced high grade prostate cancer detection over that of prostate specific antigen (AUC 0.80 vs 0.67). As an illustration of clinical implications, using 1 cutoff point for biopsy (6% risk of high grade prostate cancer) with the 4-kallikrein panel model would have eliminated unnecessary biopsies in 420 per 1,000 men (42%) while detecting high grade prostate cancer in 83 of 93 (88%). CONCLUSIONS In a multiethnic United States population, the 4-kallikrein panel demonstrated improved risk discrimination for high grade prostate cancer over conventional clinical variables (age, prostate specific antigen and digital rectal examination) as well as PCPTRC.
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Affiliation(s)
- Eric H Kim
- Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gerald L Andriole
- Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - E David Crawford
- Division of Urology, Department of Surgery, University of Colorado, Aurora, Colorado
| | - Daniel D Sjoberg
- Department of Epidemiology and Biostatistics, Clinical Chemistry Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Clinical Chemistry Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew J Vickers
- Department of Epidemiology and Biostatistics, Clinical Chemistry Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hans Lilja
- Department of Laboratory Medicine, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Surgery and Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, Sweden.
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41
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Recent progress and perspectives on prostate cancer biomarkers. Int J Clin Oncol 2016; 22:214-221. [PMID: 27730440 PMCID: PMC5378754 DOI: 10.1007/s10147-016-1049-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 01/28/2023]
Abstract
The application of prostate-specific antigen (PSA) in prostate cancer (PC) screening, diagnosis, and prognosis has improved the clinical management of PC patients. However, the PSA assay has been faced with criticism due to its potential association with over-diagnosis and subsequent overtreatment of patients with indolent disease. The United States Preventive Services Task Force incited much debate over PSA-based screening in 2012 by recommending against this approach. However, the PSA assay remains the first-line tool for the early detection of PC. This debate highlights the unmet need for non-invasive PC biomarkers with greater sensitivity and specificity that are capable of distinguishing aggressive disease from indolent disease, predicting treatment response, and guiding treatment decisions. Recent investigations into putative PC biomarkers have focused on PSA isoform assays (prostate health index, 4-kallikurein panel), PC-associated genes in the urine (PCA3 and TMPRSS2-ERG), glycan-associated biomarkers (S2, 3PSA, GCNT1, and tri- and tetra-antennary serum N-glycans), and circulating tumor cells. Although substantial efforts to identify novel PC biomarkers that might replace PSA have been put forth, the majority of the putative PC biomarkers reported in the last few years are still under investigation or validation. This review provides an overview of the current state of PC biomarker research and focuses on a few promising PC biomarkers in development.
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Leyh-Bannurah SR, Abou-Haidar H, Dell'Oglio P, Schiffmann J, Tian Z, Heinzer H, Huland H, Graefen M, Budäus L, Karakiewicz PI. Primary Gleason pattern upgrading in contemporary patients with D'Amico low-risk prostate cancer: implications for future biomarkers and imaging modalities. BJU Int 2016; 119:692-699. [PMID: 27367469 DOI: 10.1111/bju.13570] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To retrospectively assess the rate of high-grade primary Gleason upgrading (HGPGU) to primary Gleason pattern 4 or 5 in a contemporary cohort of patients with D'Amico low-risk prostate cancer including those who fulfilled Prostate Cancer Research International Active Surveillance (PRIAS) criteria, and to develop a tool for HGPGU prediction. HGPGU is a contraindication in most active surveillance (AS) and focal therapy protocols. PATIENTS AND METHODS In all, 10 616 patients with localised prostate cancer were treated at a high-volume European tertiary care centre from 2010 to 2015 with radical prostatectomy. Analyses were restricted to 1 819 patients with D'Amico low-risk prostate cancer (17.1%) with prostate-specific antigen (PSA) levels of <10.0 ng/mL, cT1c-cT2a and Gleason score ≤6, and were repeated within 772 of the men (7.3%) who fulfilled the PRIAS criteria for AS (PSA level of ≤10 ng/mL, T1c-T2, Gleason score ≤6, PSA density (PSAD) of <0.2 ng/mL2 , ≤2 positive cores). Uni- and multivariable logistic regression models were fitted, testing predictors of HGPGU. The final logistic regression model was based on the most informative variables. RESULTS There was HGPGU in 88 (4.8%) patients with D'Amico low-risk prostate cancer and in 32 (4.1%) of the subgroup who were PRIAS eligible. Multivariable analysis predicting HGPGU for the patients with D'Amico low-risk yielded three independent predictors: age, PSAD, and clinical tumour stage (P = 0.008, P = 0.005 and P = 0.021, respectively). Within the same patients, the model using all vs the most informative variables resulted in area under the curves (AUCs) of 69.2% and 68.3%, respectively. Multivariable analysis of those who were PRIAS eligible, yielded age and number of positive cores as independent predictors of HGPGU (P = 0.002 and P = 0.049, respectively; AUC 64.9%). CONCLUSIONS The low accuracy (invariably <70%) for HGPGU prediction in both patients with D'Amico low-risk prostate cancer and PRIAS eligibility indicates that these variables have poor predictive ability in contemporary patients. Despite HGPGU being a rare phenomenon, it may have life threatening implications and consequently alternatives such as biomarkers, genetic markers, or imaging modalities at re-biopsy are needed.
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Affiliation(s)
- Sami-Ramzi Leyh-Bannurah
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.,Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hiba Abou-Haidar
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.,Department of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Paolo Dell'Oglio
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.,Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jonas Schiffmann
- Department of Urology, Academic Hospital Braunschweig, Braunschweig, Germany
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Hans Heinzer
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hartwig Huland
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Graefen
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lars Budäus
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.,Department of Urology, University of Montreal Health Center, Montreal, QC, Canada
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Leyh-Bannurah SR, Dell’Oglio P, Tian Z, Schiffmann J, Shariat SF, Suardi N, Francesco M, Alberto B, Heinzer H, Huland H, Graefen M, Budäus L, Karakiewicz PI. A proposal of a new nomogram for predicting upstaging in contemporary D’Amico low-risk prostate cancer patients. World J Urol 2016; 35:189-197. [DOI: 10.1007/s00345-016-1863-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/21/2016] [Indexed: 12/28/2022] Open
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Gaudreau PO, Stagg J, Soulières D, Saad F. The Present and Future of Biomarkers in Prostate Cancer: Proteomics, Genomics, and Immunology Advancements. BIOMARKERS IN CANCER 2016; 8:15-33. [PMID: 27168728 PMCID: PMC4859450 DOI: 10.4137/bic.s31802] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 12/29/2022]
Abstract
Prostate cancer (PC) is the second most common form of cancer in men worldwide. Biomarkers have emerged as essential tools for treatment and assessment since the variability of disease behavior, the cost and diversity of treatments, and the related impairment of quality of life have given rise to a need for a personalized approach. High-throughput technology platforms in proteomics and genomics have accelerated the development of biomarkers. Furthermore, recent successes of several new agents in PC, including immunotherapy, have stimulated the search for predictors of response and resistance and have improved the understanding of the biological mechanisms at work. This review provides an overview of currently established biomarkers in PC, as well as a selection of the most promising biomarkers within these particular fields of development.
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Affiliation(s)
- Pierre-Olivier Gaudreau
- Hematologist and Medical Oncologist, Notre-Dame Hospital, CHUM Research Center, Montreal, QC, Canada
| | - John Stagg
- Associate Professor, Department of Pharmacy, Cancer Axis—Montreal Cancer Institute, Montreal, QC, Canada
| | - Denis Soulières
- Hematologist and Medical Oncologist, Notre-Dame Hospital, CHUM Research Center, Montreal, QC, Canada
- Associate Professor, Department of Medicine, University of Montreal, QC, Canada
| | - Fred Saad
- Professor and Chief of Urology, CHUM—Pavillon R, Montreal, QC, Canada
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45
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Kim EH, Andriole GL. Editorial Comment. Urology 2016; 91:17. [DOI: 10.1016/j.urology.2015.12.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Filella X, Foj L. Emerging biomarkers in the detection and prognosis of prostate cancer. Clin Chem Lab Med 2016; 53:963-73. [PMID: 25581761 DOI: 10.1515/cclm-2014-0988] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/01/2014] [Indexed: 11/15/2022]
Abstract
The prostate-specific antigen (PSA) is currently the most used tumor marker in the early detection of the prostate cancer (PCa), despite its low specificity and low negative predictive value. New biomarkers, including urine prostate cancer gene 3 (PCA3) score, Prostate Health Index (PHI), and the four-kallikrein panel, have been investigated during recent years especially with the aim of detecting aggressive PCa. Results suggest the ability of these biomarkers to improve the specificity of PSA in the detection of PCa, although there are not enough results directly comparing these biomarkers to know their complementarity. The relationship with PCa aggressiveness seems to be confirmed for PHI and for the four-kallikrein panel, but not for PCA3 score. However, available results suggest that emerging biomarkers may be useful as part of a multivariable approach for the screening and prognosis of PCa. Nevertheless, larger prospective studies comparing these biomarkers are necessary to evaluate definitely their value in the management of early PCa.
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47
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McDonald ML, Parsons JK. 4-Kallikrein Test and Kallikrein Markers in Prostate Cancer Screening. Urol Clin North Am 2016; 43:39-46. [DOI: 10.1016/j.ucl.2015.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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48
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Abstract
BACKGROUND The use of biomarkers for prostate cancer screening, diagnosis and prognosis has the potential to improve the clinical management of the patients. Owing to inherent limitations of the biomarker prostate-specific antigen (PSA), intensive efforts are currently directed towards a search for alternative prostate cancer biomarkers, particularly those that can predict disease aggressiveness and drive better treatment decisions. METHODS A literature search of Medline articles focused on recent and emerging advances in prostate cancer biomarkers was performed. The most promising biomarkers that have the potential to meet the unmet clinical needs in prostate cancer patient management and/or that are clinically implemented were selected. CONCLUSIONS With the advent of advanced genomic and proteomic technologies, we have in recent years seen an enormous spurt in prostate cancer biomarker research with several promising alternative biomarkers being discovered that show an improved sensitivity and specificity over PSA. The new generation of biomarkers can be tested via serum, urine, or tissue-based assays that have either received regulatory approval by the US Food and Drug Administration or are available as Clinical Laboratory Improvement Amendments-based laboratory developed tests. Additional emerging novel biomarkers for prostate cancer, including circulating tumor cells, microRNAs and exosomes, are still in their infancy. Together, these biomarkers provide actionable guidance for prostate cancer risk assessment, and are expected to lead to an era of personalized medicine.
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Affiliation(s)
- Sharanjot Saini
- Department of Urology, Urology Research (112J), Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA.
- University of California San Francisco, San Francisco, CA, USA.
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Ferro M, Buonerba C, Terracciano D, Lucarelli G, Cosimato V, Bottero D, Deliu VM, Ditonno P, Perdonà S, Autorino R, Coman I, De Placido S, Di Lorenzo G, De Cobelli O. Biomarkers in localized prostate cancer. Future Oncol 2016; 12:399-411. [PMID: 26768791 DOI: 10.2217/fon.15.318] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Biomarkers can improve prostate cancer diagnosis and treatment. Accuracy of prostate-specific antigen (PSA) for early diagnosis of prostate cancer is not satisfactory, as it is an organ- but not cancer-specific biomarker, and it can be improved by using models that incorporate PSA along with other test results, such as prostate cancer antigen 3, the molecular forms of PSA (proPSA, benign PSA and intact PSA), as well as kallikreins. Recent reports suggest that new tools may be provided by metabolomic studies as shown by preliminary data on sarcosine. Additional molecular biomarkers have been identified by the use of genomics, proteomics and metabolomics. We review the most relevant biomarkers for early diagnosis and management of localized prostate cancer.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Carlo Buonerba
- Medical Oncology, Department of Clinical Medicine & Surgery, University 'Federico II', Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University 'Federico II', Naples, Italy
| | - Giuseppe Lucarelli
- Department of Emergency & Organ Transplantation - Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Vincenzo Cosimato
- Department of Translational Medical Sciences, University 'Federico II', Naples, Italy
| | - Danilo Bottero
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Victor M Deliu
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Pasquale Ditonno
- Department of Emergency & Organ Transplantation - Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Sisto Perdonà
- Department of Urology, National Cancer Institute of Naples, Naples, Italy
| | - Riccardo Autorino
- Urology Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
| | - Ioman Coman
- Department of Urology 'Iuliu Hatieganu', University of Medicine & Pharmacy, 400012 Cluj-Napoca, Romania
| | - Sabino De Placido
- Medical Oncology, Department of Clinical Medicine & Surgery, University 'Federico II', Naples, Italy
| | - Giuseppe Di Lorenzo
- Medical Oncology, Department of Clinical Medicine & Surgery, University 'Federico II', Naples, Italy
| | - Ottavio De Cobelli
- Division of Urology, European Institute of Oncology, Milan, Italy.,Department of Urology 'Iuliu Hatieganu', University of Medicine & Pharmacy, 400012 Cluj-Napoca, Romania
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50
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Prostate Cancer in the Elderly. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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