Clinical Utility of Biomarkers in Localized Prostate Cancer

Leapman, Michael; Nguyen, Hao G.; Cooperberg, Matthew R.

doi:10.1007/s11912-016-0513-1

Cited by 13 publications

(11 citation statements)

References 62 publications

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“…Serum and urinary biomarkers also hold promise and offer the potential of a noninvasive simple test that might allow men to make a decision whether to avoid a repeat biopsy (Leapman et al , 2016). However, two biomarkers (prostate health index and PCA3) were recently deemed less accurate and less cost-effective when compared with an imaging-based pathway by the UK National Institute of Clinical and Health Excellence (NICE Diagnostics Guideline, 2015).…”

Section: Discussionmentioning

confidence: 99%

The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy

et al. 2017

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Background:Transrectal prostate biopsy has limited diagnostic accuracy. Prostate Imaging Compared to Transperineal Ultrasound-guided biopsy for significant prostate cancer Risk Evaluation (PICTURE) was a paired-cohort confirmatory study designed to assess diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) in men requiring a repeat biopsy.Methods:All underwent 3 T mpMRI and transperineal template prostate mapping biopsies (TTPM biopsies). Multiparametric MRI was reported using Likert scores and radiologists were blinded to initial biopsies. Men were blinded to mpMRI results. Clinically significant prostate cancer was defined as Gleason ⩾4+3 and/or cancer core length ⩾6 mm.Results:Two hundred and forty-nine had both tests with mean (s.d.) age was 62 (7) years, median (IQR) PSA 6.8 ng ml (4.98–9.50), median (IQR) number of previous biopsies 1 (1–2) and mean (s.d.) gland size 37 ml (15.5). On TTPM biopsies, 103 (41%) had clinically significant prostate cancer. Two hundred and fourteen (86%) had a positive prostate mpMRI using Likert score ⩾3; sensitivity was 97.1% (95% confidence interval (CI): 92–99), specificity 21.9% (15.5–29.5), negative predictive value (NPV) 91.4% (76.9–98.1) and positive predictive value (PPV) 46.7% (35.2–47.8). One hundred and twenty-nine (51.8%) had a positive mpMRI using Likert score ⩾4; sensitivity was 80.6% (71.6–87.7), specificity 68.5% (60.3–75.9), NPV 83.3% (75.4–89.5) and PPV 64.3% (55.4–72.6).Conclusions:In men advised to have a repeat prostate biopsy, prostate mpMRI could be used to safely avoid a repeat biopsy with high sensitivity for clinically significant cancers. However, such a strategy can miss some significant cancers and overdiagnose insignificant cancers depending on the mpMRI score threshold used to define which men should be biopsied.

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Section: Discussionmentioning

confidence: 99%

The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy

et al. 2017

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“…This information assists clinicians in assessing a patient’s suitability for active surveillance or immediate treatment. A favorable score GPS < 20, improved the confidence of patients remaining on active surveillance, but unfavorable patients should be evaluated for treatment 29, 30. Each 20 point increase in GPS is associated with a 2.3-fold increased risk of high grade disease (95% CI 1.5–3.7) and a 1.9-fold increased risk of nonorgan confined disease (95% CI 1.3–3.0) on final pathology at radical prostatectomy 31 …”

Section: Prostatic Tissue Biomarkersmentioning

confidence: 99%

Prostate cancer biomarkers: Are we hitting the mark?

McGrath

Christidis

Perera

et al. 2016

Prostate International

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PurposeLocalised prostate cancer diagnosis and management is increasingly complex due to its heterogeneous progression and prognostic subgroups. Pitfalls in current screening and diagnosis have prompted the search for accurate and invasive molecular and genetic biomarkers for prostate cancer. Such tools may be able to distinguish clinically significant cancers from less aggressive variants to assist with prostate cancer risk stratification and guide decisions and healthcare algorithms. We aimed to provide a comprehensive review of the current prostate cancer biomarkers available and in development.MethodsMEDLINE and EMBASE databases searches were conducted to identify articles pertaining to the use of novel biomarkers for prostate cancer.ResultsA growing number of novel biomarkers are currently under investigation. Such markers include urinary biomarkers, serology-based markers or pathological tissue assessments of molecular and genetic markers. While limited clinical data is present for analysis, early results appear promising. Specifically, a combination of serum and urinary biomarkers (Serum PSA + Urinary PCA3 + Urinary TMPRSS2-ERG fusion) appears to provide superior sensitivity and specificity profiles compared to traditional diagnostic approaches (AUC 0.88).ConclusionThe accurate diagnosis and risk stratification of prostate cancer is critical to ensure appropriate intervention. The development of non-invasive biomarkers can add to the information provided by current screening practices and allows for individualised risk stratification of patients. The use of these biomarkers appears to increase the sensitivity and specificity of diagnosis of prostate cancer. Further studies are necessary to define the appropriate use and time points of each biomarker and their effect on the management algorithm of prostate cancer.

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“…In Pca patients with Gleason grade 8-10, a proportion of tumor cells are so poorly differentiated that they produce relatively little PSA 3,4 . Therefore, more precise indicators of disease severity are critical for optimizing the treatment of Pca patients and may offer predictive and prognostic clinical information 5,6 .…”

Section: Introductionmentioning

confidence: 99%

XPNPEP2 is associated with lymph node metastasis in prostate cancer patients

Dai

et al. 2019

Sci Rep

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As we reported in our previous studies, TMTP1, a tumor-homing peptide, selectively targets highly metastatic tumors and their metastatic foci. Aminopeptidase P2 (XPNPEP2) is a receptor for TMTP1 tumor-homing peptide. However, the biological and clinical significance of Aminopeptidase P2 in human cancers remains unknown. In this study, the high-density multiple organ tumor tissue array was employed for the analysis of XPNPEP2 expression profiles in human specimens. The results showed that XPNPEP2 was moderately expressed in the normal prostate tissues, but significantly decreased in the prostate cancer. Hence we used TCGA, IHC, and ELISA to further analyze the expression of XPNPEP2 in tissues and serum of prostate cancer patients. In general, XPNPEP2 expression was lower in prostate cancer tissue than in normal prostate tissue, but was higher in prostate cancer tissues with local invasion and LN metastasis than in tissues with localized Pca. Western blot clarified XPNPEP2 had a secreted form in the serum. Then the serums of 128 Pca patients, 70 healthy males and 40 prostate hyperplasia patients were obtained for detecting serum XPNPEP2 levels.The results indicated that the concentration of XPNPEP2 in serums of Pca patients with LN metastasis (142.7 ± 14.40 ng/mL) were significantly higher than levels in Pca patients without LN metastasis (61.63 ± 5.50 ng/mL) ( p < 0.01). An ROC analysis revealed that the combination of PSA and XPNPEP2 was more efficient than PSA or XPNPEP2 alone for predicting LN metastasis, especially for Pca patients with low serum PSA levels. In summary, serum XPNPEP2 levels when combined with PSA levels may result in increased sensitivity for predicting LN metastasis in Pca patients, especially for patients with low serum PSA levels.

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Clinical Utility of Biomarkers in Localized Prostate Cancer

Cited by 13 publications

References 62 publications

The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy

The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy

Prostate cancer biomarkers: Are we hitting the mark?

XPNPEP2 is associated with lymph node metastasis in prostate cancer patients

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