Papel de PCA3 y SelectMDx en la optimización de la vigilancia activa en el cáncer de próstata

Active Surveillance in Prostate Cancer: Role of Available Biomarkers in Daily Practice

“…We have just published our results with SelectMDx and PCA3 in an AS setting, showing that SelectMDx showed statistically significant differences related to pathological progression-free survival (HR: 1.035; 95% CI: 1.012-1.057) (p = 0.002) with a C-index of 0.670 (95% CI: 0.529-0.810) and AUC of 0.714(95% CI: 0.603-0.825) at 5 years. The combination of both biomarkers did not improve the prediction of PP and C-index 0.630 (95% CI: 0.455-0.805) [80]. Despite the high ability of SelectMDx in predicting the likelihood of finding high-grade PCa, it has been demonstrated that its combination with mpMRI could better select candidates to AS, identifying men who harbour csPCa, hence improving the cost-effectiveness.…”

“…Therefore, at present, we can just recommend them in doubtful cases such as high-volume Gleason 3 + 3 or favourable intermediate-risk PCa where a more conservative management could be considered in case of favourable tissular marker scoring. Can detect high-grade csPCa accurately and could therefore be used in AS decision making, reducing the number of unnecessary prostate biopsies and potential overtreatment [78][79][80][81][82][83][84][85] Prospective and longitudinal studies with different biomarkers focused on AS cohorts are still missing. Prospective, well-designed studies assessing predefined clinically relevant endpoints are needed to fully assess the real potential of these biomarkers and to compare them with other diagnostic tools, such as novel predictors of grade progression and mpMRI-PRECISE criteria [85].…”