title: Presurgical Biomarker Performance in the Detection of Gleason Upgrading in Prostate Cancer.
abstract: Gleason Score (GS) upgrading is generally considered a trigger for exit to definitive treatment during active surveillance (AS). Predicting the potential for GS upgrading would be of value in assessing AS eligibility.
  
  
  
  We assessed the performance of biomarkers in presurgical specimens of expressed prostatic secretion (EPS) in this setting.
  
  
  
  Although EPS volume, total recovered RNA, and RNA expression biomarkers (TMPRSS2: ERG, PCA3, PSA) have been successful in both biopsy outcome prediction, and in the prediction of upstaging in active surveillance eligible patients, they were unable to predict upgrading in patients eligible for active surveillance under National Comprehensive Cancer Network guidelines.
  
  
  
  These biomarkers do not improve the prediction of upgrading over indications from standard clinical parameters.
  
  
  
  Additional biomarkers will be needed in this area. Cancer Epidemiol Biomarkers Prev; 25(12); 1643-5. ©2016 AACR.
authors.affiliation: Division of Urology, Department of Surgery, City of Hope, Duarte, California.
authors.forename: Kristina
authors.initials: K
authors.lastname: Wittig
authors.affiliation: Division of Urology, Department of Surgery, City of Hope, Duarte, California.
authors.forename: Johnathan L
authors.initials: JL
authors.lastname: Yamzon
authors.affiliation: Division of Biostatistics, Department of Information Sciences, City of Hope, Duarte, California.
authors.forename: David D
authors.initials: DD
authors.lastname: Smith
authors.affiliation: Division of Biostatistics, Department of Information Sciences, City of Hope, Duarte, California.|Department of Statistics, University of California - Riverside, Riverside, California.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Jeske
authors.affiliation: Division of Urology, Department of Surgery, City of Hope, Duarte, California. ssmith@coh.org.|Beckman Research Institute of the City of Hope, Duarte, California.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Smith
mesh_terms: D000951:Antigens, Neoplasm / Q000235:genetics; D014408:Biomarkers, Tumor / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D008297:Male; D060787:Neoplasm Grading / Q000379:methods*; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000235:genetics; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D012680:Sensitivity and Specificity; D012697:Serine Endopeptidases / Q000235:genetics; D000071230:Transcriptional Regulator ERG / Q000235:genetics
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C072312:ERG protein, human; D000071230:Transcriptional Regulator ERG; C479341:prostate cancer antigen 3, human; D012697:Serine Endopeptidases; C421305:TMPRSS2 protein, human; D017430:Prostate-Specific Antigen