Clinical utility of emerging biomarkers in prostate cancer liquid biopsies

Abstract

Introduction: Prostate cancer (PCa) is one of the most common malignancies in men and a major cause of cancer deaths among men worldwide. Prostate specific antigen (PSA) monitoring and histopathological examination of tumor biopsies remain gold standards in PCa diagnostics. These clinical parameters are not well suited for patient stratification, predicting and monitoring treatment response. On the other hand, liquid biopsies offer a unique opportunity to easily isolate tumor-derived material for longitudinal clinical assessment. Areas covered: In this review we focus on the clinical application of novel liquid biomarkers that have the potential to monitor and stratify patients in order to achieve better therapeutic effects and improve clinical outcomes. Enumeration and characterization of circulating tumor cells (CTCs), tumor-educated platelets, exosomes, and cell-free nucleic acids have been studied for their clinical utility in PCa diagnostics, prognostics, monitoring treatment response and guiding treatment choice. Expert opinion: Liquid biomarkers have high potential to be used for prognosis, monitoring treatment response and guiding treatment selection. Although there is a remarkable progress in PCa biomarker discovery, their clinical validation is very limited. Research should be focused on biomarker validation and the incorporation of these biomarkers in clinical practice.

Liquid biopsy reveals KLK3 mRNA as a prognostic marker for progression free survival in patients with metastatic castration‐resistant prostate cancer undergoing first‐line abiraterone acetate and prednisone treatment

“…Liquid biopsies are a promising source for biomarker analysis. Besides circulating tumor DNA (ctDNA) and circulating tumor cells (CTC), liquid biopsies also contain circulating RNAs, protein-coding messenger RNAs (mRNAs) and non-coding RNAs (ncRNAs), such as microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), all of which can be released by the tumor into the circulation [4]. Liquid biopsies are minimally invasive and therefore longitudinal sample collection and biomarker analysis is feasible.…”

Profiling of Circulating microRNAs in Prostate Cancer Reveals Diagnostic Biomarker Potential

“…In recent years, liquid biopsies (e.g., blood, urine, and other bodily fluids) have gained attention for investigating circulating tumor DNA, RNA, or microRNAs (miRNAs) in minimally invasive tests for diagnosis, prognosis, recurrence, and disease monitoring [13][14][15][16]. miRNAs are short non-coding RNAs approximately 22 nucleotides in length, which post-transcriptionally regulate gene expression of up to 60% of all human mRNAs and often play a significant role in oncogenesis [13,17,18].…”

Platelets Extracellular Vesicles as Regulators of Cancer Progression—An Updated Perspective

“…Similar observations were made in adult patients with myeloproliferative neoplasia, where the number of TF positive PMPs and endothelial derived EVs was significantly increased, which might also play a role in thrombotic complications in that group of subjects [ 112 ]. Tjon-Kon-Fat et al demonstrated that tumor educated PLTs are a source of prostate cancer biomarkers [ 113 , 114 ]. In this context it seems to be interesting to evaluate the presence and role of EVs generated from tumor-educated PLTs.…”