“The therapeutic success rate for prostate cancer can be tremendously improved if the disease is diagnosed early,” wrote Yi Lu, PhD, of the Department of Pathology at the University of Tennessee Health Science Center in Memphis, TN, in the Journal of Cancer in 2010.3 “Thus, a successful therapy for this disease depends heavily on the clinical indicators (biomarkers) for early detection of the presence and progression of the disease, as well as the prediction after the clinical intervention. However, the current clinical biomarkers for prostate cancer are not ideal as there remains a lack of reliable biomarkers that can specifically distinguish between those patients who should be treated adequately to stop the aggressive form of the disease and those who should avoid overtreatment of the indolent form.”

The following presentations from the 2014 Genitourinary Cancers Symposium illustrate the depth and breadth of the increasing role biomarkers play in caring for men with prostate cancer.6


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Surveillance

  • Predict outcomes in men with favorable-risk prostate cancer in active surveillance using the prostate health index. (Abstract 81)
  • Validate RNA expression levels using matched formalin-fixed, paraffin-embedded biopsy in lieu of radical prostatectomy specimens to stratify patients for active surveillance. (Abstract 85)
  • Evaluate chromosome 8 alterations and phosphatase and tensin homolog loss in Gleason grade 3 tumors as biomarkers to select men for active surveillance. (Abstract 93)
  • Predict clinical risk in men enrolled in an active surveillance program using quantitative image analysis of morphology and immunofluorescent biomarkers from prostate needle biopsy. (Abstract 111)

Predictive

  • Use NBN gain to predict biochemical relapse following image-guided radiotherapy (IGRT) for intermediate-risk prostate cancer: “If validated in independent IGRT cohorts, NBN gain could be the first prostate cancer predictive biomarker to facilitate local treatment decisions using precision medicine approaches.” (Abstract 26)
  • Measure dehydroepiandrosterone levels using liquid chromatography/mass spectroscopy at baseline and during treatment to predict which patients with metastatic castration-resistant prostate cancer (mCRPC) respond to treatment with abiraterone acetate. (Abstract 53)
  • Determine feasibility of DNA copy number and whole-exome sequencing analysis of circulating tumor cells (CTCs) from men with metastatic castrate-resistant prostate cancer (mCRPC) receiving enzalutamide to identify predictive biomarkers of efficacy and clinical resistance. (Abstract 65)
  • Stratify patients and design natural killer (NK)-based immunotherapeutic strategies using NK cell receptors as potential biomarkers. (Abstract 95)
  • Examine molecular characterizations of CTCs and CTC subpopulations in progressive mCRPC as “putative predictive biomarkers” for real-time tumor assessment. (Abstract 132)
  • Identify biologic and inflammatory markers to predict clinical response to sipuleucel-T in CRPC. (Abstract 134)
  • Determine response to satraplatin by analyzing correlation between molecular signatures and treatment response using pretreatment metastatic tumor biopsies from patients with docetaxel-refractory mCRPC. (Abstract 170)
  • Validate predictive models and biomarkers of radiotherapy toxicity to reduce side effects. (Abstract 276)

Diagnostic and Prognostic

  • Develop a scoring system to diagnose prostate cancer and predict prognosis by combining two algorithms using urine and plasma biomarkers. (Abstract 163)