Biomarkers of Aggressive Prostate Cancer at Diagnosis
In the United States, prostate cancer (CaP) remains the second leading cause of cancer deaths in men. CaP is predominantly indolent at diagnosis, with a small fraction (25–30%) representing an aggressive subtype (Gleason score 7–10) that is prone to metastatic progression. This fact, coupled with th...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/3/2185 |
| _version_ | 1797624400904716288 |
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| author | Brock E. Boehm Monica E. York Gyorgy Petrovics Indu Kohaar Gregory T. Chesnut |
| author_facet | Brock E. Boehm Monica E. York Gyorgy Petrovics Indu Kohaar Gregory T. Chesnut |
| author_sort | Brock E. Boehm |
| collection | DOAJ |
| description | In the United States, prostate cancer (CaP) remains the second leading cause of cancer deaths in men. CaP is predominantly indolent at diagnosis, with a small fraction (25–30%) representing an aggressive subtype (Gleason score 7–10) that is prone to metastatic progression. This fact, coupled with the criticism surrounding the role of prostate specific antigen in prostate cancer screening, demonstrates the current need for a biomarker(s) that can identify clinically significant CaP and avoid unnecessary biopsy procedures and psychological implications of being diagnosed with low-risk prostate cancer. Although several diagnostic biomarkers are available to clinicians, very few comparative trials have been performed to assess the clinical effectiveness of these biomarkers. It is of note, however, that a majority of these clinical trials have been over-represented by men of Caucasian origin, despite the fact that African American men have a 1.7 times higher incidence and 2.1 times higher rate of mortality from prostate cancer. Biomarkers for CaP diagnosis based on the tissue of origin include urine-based gene expression assays (PCA3, Select MDx, ExoDx Prostate IntelliScore, Mi-Prostate Score, PCA3-PCGEM1 gene panel), blood-based protein biomarkers (4K, PHI), and tissue-based DNA biomarker (Confirm MDx). Another potential direction that has emerged to aid in the CaP diagnosis include multi-parametric magnetic resonance imaging (mpMRI) and bi-parametric magnetic resonance imaging (bpMRI), which in conjunction with clinically validated biomarkers may provide a better approach to predict clinically significant CaP at diagnosis. In this review, we discuss some of the adjunctive biomarker tests along with newer imaging modalities that are currently available to help clinicians decide which patients are at risk of having high-grade CaP on prostate biopsy with the emphasis on clinical utility of the tests across African American (AA) and Caucasian (CA) men. |
| first_indexed | 2024-03-11T09:41:53Z |
| format | Article |
| id | doaj.art-7639ecadc62c48f089631d4e3398f783 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T09:41:53Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-7639ecadc62c48f089631d4e3398f7832023-11-16T16:53:57ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-01-01243218510.3390/ijms24032185Biomarkers of Aggressive Prostate Cancer at DiagnosisBrock E. Boehm0Monica E. York1Gyorgy Petrovics2Indu Kohaar3Gregory T. Chesnut4Urology Service, Walter Reed National Military Medical Center, Bethesda, MD 20814, USASchool of Medicine, Uniformed Services University of Health Science, Bethesda, MD 20814, USACenter for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20814, USACenter for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20814, USAUrology Service, Walter Reed National Military Medical Center, Bethesda, MD 20814, USAIn the United States, prostate cancer (CaP) remains the second leading cause of cancer deaths in men. CaP is predominantly indolent at diagnosis, with a small fraction (25–30%) representing an aggressive subtype (Gleason score 7–10) that is prone to metastatic progression. This fact, coupled with the criticism surrounding the role of prostate specific antigen in prostate cancer screening, demonstrates the current need for a biomarker(s) that can identify clinically significant CaP and avoid unnecessary biopsy procedures and psychological implications of being diagnosed with low-risk prostate cancer. Although several diagnostic biomarkers are available to clinicians, very few comparative trials have been performed to assess the clinical effectiveness of these biomarkers. It is of note, however, that a majority of these clinical trials have been over-represented by men of Caucasian origin, despite the fact that African American men have a 1.7 times higher incidence and 2.1 times higher rate of mortality from prostate cancer. Biomarkers for CaP diagnosis based on the tissue of origin include urine-based gene expression assays (PCA3, Select MDx, ExoDx Prostate IntelliScore, Mi-Prostate Score, PCA3-PCGEM1 gene panel), blood-based protein biomarkers (4K, PHI), and tissue-based DNA biomarker (Confirm MDx). Another potential direction that has emerged to aid in the CaP diagnosis include multi-parametric magnetic resonance imaging (mpMRI) and bi-parametric magnetic resonance imaging (bpMRI), which in conjunction with clinically validated biomarkers may provide a better approach to predict clinically significant CaP at diagnosis. In this review, we discuss some of the adjunctive biomarker tests along with newer imaging modalities that are currently available to help clinicians decide which patients are at risk of having high-grade CaP on prostate biopsy with the emphasis on clinical utility of the tests across African American (AA) and Caucasian (CA) men.https://www.mdpi.com/1422-0067/24/3/2185prostate cancerdiagnosisbiomarkersrace |
| spellingShingle | Brock E. Boehm Monica E. York Gyorgy Petrovics Indu Kohaar Gregory T. Chesnut Biomarkers of Aggressive Prostate Cancer at Diagnosis International Journal of Molecular Sciences prostate cancer diagnosis biomarkers race |
| title | Biomarkers of Aggressive Prostate Cancer at Diagnosis |
| title_full | Biomarkers of Aggressive Prostate Cancer at Diagnosis |
| title_fullStr | Biomarkers of Aggressive Prostate Cancer at Diagnosis |
| title_full_unstemmed | Biomarkers of Aggressive Prostate Cancer at Diagnosis |
| title_short | Biomarkers of Aggressive Prostate Cancer at Diagnosis |
| title_sort | biomarkers of aggressive prostate cancer at diagnosis |
| topic | prostate cancer diagnosis biomarkers race |
| url | https://www.mdpi.com/1422-0067/24/3/2185 |
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