The role of the prostate cancer gene 3 urine test in addition to serum prostate-specific antigen level in prostate cancer screening among breast cancer, early-onset gene mutation carriers

Rare Germline Pathogenic Mutations of DNA Repair Genes Are Most Strongly Associated with Grade Group 5 Prostate Cancer

BACKGROUND

Rare germline mutations in several genes, primarily DNA repair genes, have been proposed to predict worse prognosis of prostate cancer (PCa).

OBJECTIVE

To compare the frequency of germline pathogenic mutations in commonly assayed PCa genes between high- and low-grade PCa in patients initially presenting with clinically localized disease.

DESIGN, SETTING, AND PARTICIPANTS

A retrospective case-case study of 1694 PCa patients who underwent radical prostatectomy at Johns Hopkins Hospital, including 706 patients with high-grade (grade group [GG] 4 and GG5) and 988 patients with low-grade (GG1) disease. Germline DNA was sequenced for 13 candidate PCa genes using a targeted next-generation sequencing assay by Ambry Genetics.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Carrier rates of pathogenic mutations were compared between high- and low-grade PCa patients using the Fisher's exact test.

RESULTS AND LIMITATIONS

Overall, the carrier rate of germline pathogenic mutations in the 13 genes was significantly higher in high-grade patients (8.64%) than in low-grade patients (3.54%, p = 9.98 × 10^-6). Individually, significantly higher carrier rates for patients with high- versus low-grade PCa were found for three genes: ATM (2.12% and 0.20%, respectively, p = 9.35 × 10^-5), BRCA2 (2.55% and 0.20%, respectively, p = 8.99 × 10^-6), and MSH2 (0.57% and 0%, respectively, p = 0.03). The mutation carrier rate was significantly higher in patients with GG5 than in patients with GG1 disease for the 13 genes overall (13.07% and 3.54%, respectively, p = 1.27 × 10^-9); for the three genes ATM, BRCA2, and MSH2 (7.73% and 0.40%, respectively, p = 3.20 × 10^-13); and for the remaining nine DNA repair genes (5.07% and 2.43%, respectively, p = 0.02).

CONCLUSIONS

In men undergoing treatment for clinically localized disease, pathogenic mutations in 13 commonly assayed genes, especially ATM, BRCA2, and MSH2, are most strongly associated with GG5 PCa. These findings emphasize the importance of genetic testing in men with high-grade PCa, particularly GG5 disease, to inform both treatment decisions and familial risk assessment.

PATIENT SUMMARY

Prostate cancer in men with inherited mutations in 13 commonly assayed susceptibility genes is more likely to be high-grade, high-risk disease.

Graphene-based biosensors for the detection of prostate cancer protein biomarkers: a review

Prostate cancer (PC) is the sixth most common cancer type in the world, which causes approximately 10% of total cancer fatalities. The detection of protein biomarkers in body fluids is the key topic for the diagnosis and prognosis of PC. Highly sensitive screening of PC is the most effective approach for reducing mortality. Thus, there are a growing number of literature that recognizes the importance of new technologies for early diagnosis of PC. Graphene is playing an important role in the biosensor field with remarkable physical, optical, electrochemical and magnetic properties. Many recent studies demonstrated the potential of graphene materials for sensitive detection of protein biomarkers. In this review, the graphene-based biosensors toward PC analysis are mainly discussed in two groups: Firstly, novel biosensor interfaces were constructed through the modification of graphene materials onto sensor surfaces. Secondly, ingenious signal amplification strategies were developed using graphene materials as catalysts or carriers. Graphene-based biosensors have exhibited remarkable performance with high sensitivities, wide detection ranges, and long-term stabilities.

A Novel Approach Based on Point Cut Set to Predict Associations of Diseases and LncRNAs

Background:

In recent years, more evidence have progressively indicated that Long non-coding RNAs (lncRNAs) play vital roles in wide-ranging human diseases, which can serve as potential biomarkers and drug targets. Comparing with vast lncRNAs being found, the relationships between lncRNAs and diseases remain largely unknown.

Objective:

The prediction of novel and potential associations between lncRNAs and diseases would contribute to dissect the complex mechanisms of disease pathogenesis. associations while known disease-lncRNA associations are required only.

Method:

In this paper, a new computational method based on Point Cut Set is proposed to predict LncRNA-Disease Associations (PCSLDA) based on known lncRNA-disease associations. Compared with the existing state-of-the-art methods, the major novelty of PCSLDA lies in the incorporation of distance difference matrix and point cut set to set the distance correlation coefficient of nodes in the lncRNA-disease interaction network. Hence, PCSLDA can be applied to forecast potential lncRNAdisease associations while known disease-lncRNA associations are required only.

Results:

Simulation results show that PCSLDA can significantly outperform previous state-of-the-art methods with reliable AUC of 0.8902 in the leave-one-out cross-validation and AUCs of 0.7634 and 0.8317 in 5-fold cross-validation and 10-fold cross-validation respectively. And additionally, 70% of top 10 predicted cancer-lncRNA associations can be confirmed.

Conclusion:

It is anticipated that our proposed model can be a great addition to the biomedical research field.

Screening and Detection of Prostate Cancer-Review of Literature and Current Perspective

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.

Implications of High Rates of Metastatic Prostate Cancer in BRCA2 Mutation Carriers

BACKGROUND

Patients with germline BRCA2 gene mutations (BRCA2mut) have more aggressive prostate cancer. Analysis of all reported germline BRCA2mut prostate cancer cases allows better understanding of the clinicopathologic features and survival outcomes of these men.

METHODS

A systematic review was performed with the MEDLINE database to capture articles evaluating clinicopathologic characteristics of men with BRCA2mut associated prostate cancer. Inclusion criteria were at least five subjects, confirmation of BRCA2mut status, and data for at least 2 clinical parameters of disease. Meta-analysis was performed on outcomes data. Chi-squared tests were used to compare disease features among men undergoing formal versus ad hoc screening, as well as an age of diagnosis less than versus greater than 65 years. Rates of metastatic disease among BRCA2mut cases were compared to rates among non-carrier control subjects and the general population using the SEER database.

RESULTS

Twelve out of 289 studies met our inclusion criteria, representing 261 BRCA2mut men. Among carriers, the median age at diagnosis was 62 years and median PSA was 15 ng/dl with 95% of men having a PSA>3. Over 40% of BRCA2mut patients had T3/T4 disease and over 25% were metastatic at presentation. Survival was worse in BRCA2mut men with prostate cancer when compared to non-BRCA2mut subjects. BRCA2mut carriers had significantly higher rates of metastatic disease (18%) versus non-carrier controls (8%) and the SEER population (4%).

CONCLUSIONS

BRCA2mut carriers are more likely to have poor risk of prostate cancer at presentation and exhibit worse oncologic outcomes relative to non-carriers, including a fourfold increase in metastatic disease. Younger men and those undergoing formal screening present with less advanced disease which supports a need for earlier identification and screening protocols. Additionally, this population may benefit from alternative therapeutic paradigms. Prostate 76:1135-1145, 2016. © 2016 Wiley Periodicals, Inc.

What's new in screening in 2015?

PURPOSE OF REVIEW

The aim of this review was to highlight important articles in the field of prostate cancer screening published during 2015 and early 2016. Four major areas were identified for the purpose: screening strategies, post-United States Preventive Services Task Force (USPSTF) 2011-2012, screening trends/patterns, and shared decision making.

RECENT FINDINGS

Several studies furthered the evidence that screening reduces the risk of metastasis and death from prostate cancer. Multiplex screening strategies are of proven benefit; genetics and MRI need further evaluation. Prostate-specific antigen (PSA) screening rates declined in men above age of 50 years, as did the overall prostate cancer incidence following the USPSTF 2011-2012 recommendation against PSA. The consequences of declining screening rates will become apparent in the next few years. More research is needed to identify the most optimal approach to engage in, and implement, an effective shared decision-making in clinical practice.

SUMMARY

Data emerging in 2015 provided evidence on the question of how best to screen and brought more steps in the right direction of 'next-generation prostate cancer screening'. Screening is an ongoing process in all men regardless of whether or not they might benefit from early detection and treatment. After the USPSTF 2011-2012 recommendation, the rates of PSA testing are declining; however, this decline is observed in all men and not solely in those who will not benefit from the screening. The long-term effect of this recommendation might not be as anticipated. More studies are needed on how to implement the best available evidence on who, and when, to screen in clinical practice.