Potential Utility of Novel Biomarkers in Active Surveillance of Low-Risk Prostate Cancer.
Active surveillance (AS) is now an accepted management strategy for men with low-risk localized prostate cancer (PCa). However, detecting disease progression in a patient selected for AS remains a challenge. It is crucial to know what will serve as the best parameter to correctly identify tumors that progress to a more aggressive phenotype so as not to miss the window of curability. Several biomarkers are now being actively investigated as novel tools to improve PCa risk assessments. To date, several serum, urinary, and tissue biomarkers have shown promising prognostic value. %[-2]proPSA and PHI showed improved predictive value for an unfavorable biopsy conversion at annual surveillance biopsy in the AS program. PCA3 and TMPRSS2:ERG had additional independent predictive value for the prediction of PCa detection and progression, although PCA3 was limited in predicting aggressive cancer. Other tissue biomarkers also showed promising ability to predict disease progression. Although several of these novel biomarkers have an improved predictive accuracy that is better than classical parameters, there is still a need for further well-designed, large, multicenter, prospective trials to avoid common bias and clinical validation.
Department of Urology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
Jeong Hyun
JH
Kim
Department of Urology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam 463-707, Republic of Korea.
Sung Kyu
SK
Hong
D000951:Antigens, Neoplasm / Q000235:genetics; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics* / Q000652:urine; D018450:Disease Progression; D006801:Humans; D008297:Male; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000097:blood / Q000235:genetics* / Q000473:pathology / Q000652:urine; D018570:Risk Assessment
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015514:Oncogene Proteins, Fusion; C515553:TMPRSS2-ERG fusion protein, human; C479341:prostate cancer antigen 3, human