Novel biomarkers for guiding treatment for prostate cancer

Risk stratification is a cornerstone of the clinical management of nonmetastatic prostate cancer. Conventional risk stratification has relied on clinical and pathologic variables, which allow for patients to be placed into risk groups that help guide prognostication and treatment recommendations. However, the performance of conventional risk stratification systems is suboptimal, leading to undertreatment for some patients and overtreatment (with potentially avoidable side-effects) for others. In recent years, a number of novel biomarkers, with potential to significantly advance risk stratification, have appeared, including molecular, imaging, and digital pathology biomarkers. This review summarizes the technologies behind these novel biomarkers, their established clinical roles, challenges and limitations, and future directions.