Prognostic Genomic Tissue-Based Biomarkers in the Treatment of Localized Prostate Cancer

Abstract

In localized prostate cancer clinicopathologic variables have been used to develop prognostic nomograms quantifying the probability of locally advanced disease, of pelvic lymph node and distant metastasis at diagnosis or the probability of recurrence after radical treatment of the primary tumor. These tools although essential in daily clinical practice for the management of such a heterogeneous disease, which can be cured with a wide spectrum of treatment strategies (i.e., active surveillance, RP and radiation therapy), do not allow the precise distinction of an indolent instead of an aggressive disease. In recent years, several prognostic biomarkers have been tested, combined with the currently available clinicopathologic prognostic tools, in order to improve the decision-making process. In the following article, we reviewed the literature of the last 10 years and gave an overview report on commercially available tissue-based biomarkers and more specifically on mRNA-based gene expression classifiers. To date, these genomic tests have been widely investigated, demonstrating rigorous quality criteria including reproducibility, linearity, analytical accuracy, precision, and a positive impact in the clinical decision-making process. Albeit data published in literature, the systematic use of these tests in prostate cancer is currently not recommended due to insufficient evidence.

H1299R Variant in Factor V and Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis Protocol

“…The Newcastle Ottawa Scale (NOS) recommended by the Agency for Healthcare Research and Quality will be employed to assess the quality of articles, as previously reported by Ingrosso et al [ 18 ]. A total of 9 key criteria will be judged.…”

Prostate cancer histopathology using label-free multispectral deep-UV microscopy quantifies phenotypes of tumor aggressiveness and enables multiple diagnostic virtual stains

“…Advanced methods using genetic profiling, for example, provide a wealth of information but have shown limited success in predicting the prognosis of cancer patients 14 – 20 . The poor predictive power may be attributed to the vast genetic heterogeneity of tumors, which makes it extremely difficult to identify a unique set of mutations that provide reliable prognostic information.…”

Special Issue “Cancer Biomarker Research and Personalized Medicine”

“…In patients that have already been diagnosed with cancer, it can be challenging to stratify those with tumors that are less likely to progress from patients with tumors that are more aggressive and therefore require treatment intensification; tumor heterogeneity contributes greatly to this problem. While the early diagnosis of cancer is crucial for enhancing the survival of patients, the identification of biomarkers at the time of diagnosis that can give an indication of cancer aggressiveness is possibly the greatest unmet clinical need for many cancer types [2,7]. Prognostic biomarkers identify the likelihood of disease recurrence or progression; these factors are crucial to decision-making processes in the clinic, helping clinicians determine the most appropriate treatment for each patient.…”

“…Prognostic biomarkers identify the likelihood of disease recurrence or progression; these factors are crucial to decision-making processes in the clinic, helping clinicians determine the most appropriate treatment for each patient. Several publications within this Special Issue explored prognostic biomarkers, focusing on the development of prognostic tissue-based biomarkers in ovarian cancer [8], prostate cancer [2,7] and renal cell carcinoma [9], in addition to prognostic liquid-based biomarkers in prostate cancer [2], bladder cancer [10] and head and neck cancer [11]. Studies published within the Special Issue also show how cancer prognosis is moving towards the use of imaging, rather than relying on tissue/liquid biomarkers alone [12].…”