Metabolomics-Based Liquid Biopsy for Predicting Clinically Significant Prostate Cancer

Area of Science:

• Biochemistry
• Oncology
• Biomarker Discovery

Background:

• Prostate cancer (PC) is a leading cause of cancer death in men.
• Prostate-specific antigen (PSA) testing lacks specificity, leading to overdiagnosis and overtreatment of clinically insignificant PC (isPC).
• Magnetic resonance imaging (MRI) aids detection but is costly and has limitations.

Purpose of the Study:

• To review studies on blood and urine metabolomics for identifying biomarkers of significant PC (sPC).
• To assess the potential of metabolomics as a tool for risk stratification in PC.
• To compare the efficacy of metabolomic panels against traditional methods like PSA testing.

Main Methods:

• Systematic review of studies investigating metabolomics in PC.
• Analysis of metabolite changes in blood and urine samples from PC patients.
• Evaluation of identified metabolic panels for sPC prediction accuracy.

Main Results:

• Significant metabolite alterations in sPC involve fatty acid, sphingolipid, glycolysis, citric acid cycle, purine/pyrimidine, and tyrosine/phenylalanine metabolism.
• Increased lactate and phenylalanine, decreased tyrosine, xanthine, and histidine levels were noted in sPC patients.
• Metabolic panels, especially urine-based tests, demonstrated superior predictive performance compared to PSA, particularly when combined with clinical factors.

Conclusions:

• Metabolomics-based liquid biopsies hold significant potential for improving sPC detection.
• Standardization of protocols, integration with MRI, and validation in large cohorts are crucial for clinical translation.
• Further research is needed to overcome methodological heterogeneity and enhance model credibility for widespread adoption.