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Liquid biomarkers in active surveillance.
1Department of Urologic Surgery, University of California Davis Comprehensive Cancer Center, 4860 Y Street, Suite 3500, Sacramento, CA, 95864, USA. mdallera@ucdavis.edu.
World Journal of Urology
|February 16, 2021
Summary
New liquid biomarkers show promise for prostate cancer management. These include serum and urine tests that can aid in selecting patients for active surveillance and monitoring disease progression.
Area of Science:
- Urology
- Oncology
- Biomarker Discovery
Background:
- Prostate cancer diagnosis and risk assessment have evolved with new biomarkers.
- Tissue-based assays provide molecular risk assessment post-diagnosis.
- Liquid biomarkers (serum, urine) are emerging for pre-biopsy settings and active surveillance.
Purpose of the Study:
- To review available liquid biomarkers for prostate cancer detection and risk prediction.
- To assess the utility of these biomarkers in the context of active surveillance (AS).
Main Methods:
- Literature search of PubMed for original publications on prostate cancer biomarkers in blood, urine, or semen.
- Inclusion of studies with defined patient criteria and biomarker descriptions.
- Focus on biomarkers relevant for AS patient selection and monitoring.
Main Results:
- Prostate-specific antigen (PSA) is a primary biomarker for diagnosis and treatment; current AS guidelines use PSA levels (<10 ng/ml) and clinical factors for selection.
- PSA changes correlate with AS outcomes but lack sensitivity for isolated treatment decisions.
- Advanced biomarkers like Prostate Health Index (phi) and 4K Score show potential for predicting high-grade cancer and guiding biopsies, though further validation is needed.
- Urine-based biomarkers such as PCA3 and TMPRSS2:ERG have also been explored for AS.
Conclusions:
- Multiple serum and urine liquid biomarkers are available for prostate cancer management.
- Serum PSA is currently used for AS patient selection and monitoring.
- Integrating PSA kinetics with clinical data can optimize AS strategies, reducing disease burden and costs.
- Novel liquid biomarkers hold future promise for enhancing prostate cancer surveillance.
