title: Molecular Profiles of Prostate Cancer: To Treat or Not to Treat.
abstract: A major dilemma in the selection of treatment for men with prostate cancer is the difficulty in accurately characterizing the risk posed by the cancer. This uncertainty has led physicians to recommend aggressive therapy for most men diagnosed with prostate cancer and has led to concerns about the benefits of screening and the adverse consequences of excessive treatment. Genomic analyses of prostate cancer reveal distinct patterns of alterations in the genomic landscape of the disease that show promise for improved prediction of prognosis and better medical decision making. Several molecular profiles are now commercially available and are being used to inform medical decisions. This article describes the clinical tests available for distinguishing aggressive from nonaggressive prostate cancer, reviews the new genomic tests, and discusses their advantages and limitations and the evidence for their utility in various clinical settings.
authors.affiliation: Department of Urology, Meir Medical Center, Kefar Sava, 4428164, Israel; email: sternberg.itay@clalit.org.il.
authors.forename: Itay A
authors.initials: IA
authors.lastname: Sternberg
authors.affiliation: Department of Urology, Princess Alexandra Hospital and Australian Prostate Cancer Research Center, Queensland University of Technology, Brisbane, Queensland, Australia; email: ian.vela@qut.edu.au.
authors.forename: Ian
authors.initials: I
authors.lastname: Vela
authors.affiliation: Department of Surgery and the Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, New York 10065; email: scardinp@mskcc.org.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Scardino
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D056915:DNA Copy Number Variations; D020869:Gene Expression Profiling / Q000379:methods*; D006801:Humans; D008297:Male; D018579:Patient Selection; D011471:Prostatic Neoplasms / Q000097:blood / Q000235:genetics* / Q000473:pathology / Q000628:therapy*; D040901:Proteomics; D018570:Risk Assessment
chemical_list: D014408:Biomarkers, Tumor
keywords: active surveillance; genomic classifier; risk stratification