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Biomarcadores Moleculares y Genéticos en la Vigilancia Activa del Cáncer de Próstata: Desarrollos Recientes y

Stephanie F Smith^1,2, Robert D Mills^1,2, Colin S Cooper¹

¹Department of Metabolic Health, Norwich Medical School, Bob Champion Research and Education Building, University of East Anglia, Norwich NR4 7UQ, UK.

|January 28, 2026

Resumen

Nuevos biomarcadores moleculares y genéticos prometen mejorar la vigilancia activa (VA) en el manejo del cáncer de próstata. Estas herramientas pueden reducir la clasificación errónea y predecir mejor la progresión de la enfermedad, mejorando la atención personalizada.

Área de la Ciencia:

Oncología; Genética; Descubrimiento de Biomarcadores

Sus antecedentes:

La vigilancia activa (VA) es estándar para el cáncer de próstata localizado, con el objetivo de prevenir el sobretratamiento. Los desafíos en la VA incluyen la clasificación errónea diagnóstica y la predicción de la progresión de la enfermedad. Los biomarcadores moleculares y genéticos ofrecen soluciones potenciales para la selección y el monitoreo de pacientes.

Objetivo del estudio:

Revisar los biomarcadores para la vigilancia activa en el cáncer de próstata. Discutir cómo los biomarcadores pueden abordar los desafíos en la VA. Evaluar el estado actual y las direcciones futuras del uso de biomarcadores en la VA.

Principales métodos:

Revisión narrativa de estudios de 2000-2025. Búsquedas realizadas en PubMed y Embase. Se revisaron guías internacionales y listas de referencias, priorizando publicaciones de alto impacto.

Principales resultados:

Los biomarcadores en sangre y orina (p. ej., PHI, 4K score, ExoDx, SelectMDx, PUR) se correlacionan con la progresión. La evidencia es más sólida para la enfermedad de Gleason Grado 1; limitada para GG2. Las barreras incluyen tamaños de estudio pequeños, puntos finales sustitutos, costo y resultados discordantes con la RMN.

Conclusiones:

Los biomarcadores prometen mejorar la precisión de la VA y la predicción de la progresión. Se necesita más investigación sobre los puntos de corte clínicamente relevantes y la integración de la RMN. La VA guiada por biomarcadores podría personalizar el tratamiento y minimizar el daño.

Palabras clave:

vigilancia activa biomarcadores vesículas extracelulares biopsia líquida cáncer de próstata

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