Methylation-based biomarkers for early detection of urological cancer

Genitourinary (prostate, bladder, and kidney) cancers together comprise the most common type of human neoplasms. As a common feature to these types of malignancy, the disease is frequently asymptomatic at its earlier stages, when curative treatment is most likely to be successful. Moreover, available tests for genitourinary cancer screening (mostly directed to prostate cancer) are characterized by variable (usually low) sensitivity and specificity, preventing a consensual support for their routine use by the medical community. Thus, the timely and accurate detection of GU cancer remains a significant clinical challenge. Over the last decade, a new generation of cancer biomarkers, based on the characterization of the methylome, has emerged and has showed promise in the detection of several common malignant tumors. The investigation of novel genitourinary cancer methylation-based markers constitutes an attractive and fast-growing research field, and several studies reported on the feasibility of examining these markers in body fluids (urine and blood) for early, noninvasive cancer detection. Importantly, the use of quantitative, high-throughput techniques enables relatively easy and reproducible detection of hypermethylation at multiple gene loci in a single test, thus facilitating its translation to the clinics. Although available data is still insufficient to support the clinical implementation of these markers at the present time, further developments in methylation analysis are likely to provide valuable tests for genitourinary cancer screening and management.