In recent years, several biomarkers alternative to standard prostate specific antigen (PSA) for prostate cancer (PCa) diagnosis have become available. The aim of this systematic review is to assess the current knowledge about alternative serum and urinary biomarkers for the diagnosis of PCa. Material and Methods A research was conducted in Medline, restricted to English language articles published between December 2014 and June 2018 with the aim to update previously published series on PCa biomarkers. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria were used for selecting studies with the lowest risk of bias. Results Emerging role and actual controversies on serum and urine alternative biomarkers to standard PSA for PCa diagnosis, staging and prognosis assessment, such as prostate health index (PHI), PCA3, ConfirmMDx, Aberrant PSA glycosylation, MiPS, miRNAs are critically presented in the current review. Conclusions Although the use of several biomarkers have been recommended or questioned by different international guidelines, larger prospective randomized studies are still necessary to validate their efficacy in PCa detection, discrimination, prognosis and treatment effectiveness. To date, only PHI and 4Kscore have showed a clinical relevance for discriminating more aggressive PCa. Furthermore, a new grading classification based on molecular features relevant for PCa risk-stratification and tailoring treatment is still needed.
Current medicinal chemistry. 2018 Sep 13 [Epub ahead of print]
Umberto Anceschi, Gabriele Tuderti, Franco Lugnani, Piermario Biava, Gianni Malossini, Lorenzo Luciani, Tommaso Cai, Davide Marsiliani, Alessio Filianoti, Daniele Mattevi, Manuela Costantini, Leonardo Misuraca, Giuseppe Simone
Department of Urology, Santa Chiara Regional Hospital, Trento. Italy., Department of Urology, "Regina Elena" National Cancer Institute, Rome. Italy., Department of Urology, Salus Clinic, Trieste. Italy., Scientific Institute of Research and Care Multimedica, Milan. Italy., Department of Urology, Santa Maria Goretti Hospital, Latina. Italy.