Abstract
Prostate cancer is the most prevalent non-skin cancer in men and is the leading cause of cancer-related death. Early detection of prostate cancer is largely determined by a widely used prostate specific antigen (PSA) blood test and biopsy is performed for definitive diagnosis. Prostate cancer is asymptomatic in the early stage of the disease, comprises of diverse clinico-pathologic and progression features, and is characterized by a large subset of the indolent cancer type. Therefore, it is critical to develop an individualized approach for early detection, disease stratification (indolent vs. aggressive), and prediction of treatment response for prostate cancer. There has been remarkable progress in prostate cancer biomarker discovery, largely through advancements in genomic technologies. A rich array of prostate cancer diagnostic and prognostic tests has emerged for serum (4K, phi), urine (Progensa, T2-ERG, ExoDx, SelectMDx), and tumor tissue (ConfirmMDx, Prolaris, Oncoytype DX, Decipher). The development of these assays has created new opportunities for improving prostate cancer diagnosis, prognosis, and treatment decisions. While opening exciting opportunities, these developments also pose unique challenges in terms of selecting and incorporating these assays into the continuum of prostate cancer patient care.
Highlights
Prostate cancer is a major cause of morbidity and mortality worldwide
With the advent of generation sequencing (NGS) and sensitive Circulating Tumor Cell (CTC) detection assays performed in the blood-plasma of cancer patients, CTCs and circulating cell free tumor DNAs are emerging as promising liquid biopsy tools in oncology
A recent study on 1005 patients with nonmetastatic, clinically detected cancers found that the CancerSEEK test, a blood test based on mutations in cf DNA and levels of circulating proteins in blood, was positive in a median of 70% of the eight cancer types
Summary
Prostate cancer is a major cause of morbidity and mortality worldwide. It is the second most frequent cancer and the fifth leading cause of cancer death in men [1]. Screening or early detection biomarkers may predict the disease during a man’s asymptomatic state of cancer progression. Diagnostic biomarkers can predict cancer in patients suspected of having a disease, while prognostic biomarkers predict the course of disease progression. Predictive biomarkers can predict risk of disease onset/progression or response to a given therapy in a subset of the patient population. The present review is based on the current state of knowledge of available diagnostic and prognostic molecular markers in prostate cancer, as well as those under development, and discusses their utility in the clinic
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