Prostate cancer and the role of biomarkers.

To review available prostate cancer biomarkers and their performance in a clinical order, from prostate cancer detection, to treatment of localized and advanced disease.

We used an electronic literature search of the PubMed database using the key words "prostate biomarkers," "genomic markers," and "prostate cancer screening," as well as specific biomarkers, until March 2019.

Prostate-specific antigen (PSA) lacks sensitivity for prostate cancer detection, and PSA derivatives have slightly improved its specificity, but have not resolved the limitations of PSA screening. Prostate cancer biomarkers have emerged as an ancillary tool to guide the clinical decision-making in different clinical scenarios. Urine-based tests can identify patients who may benefit from a prostate biopsy, and issue-based markers are helpful in guiding the decision regarding a second biopsy, stratifying patient with newly diagnosed prostate cancer to active surveillance or treatment, and identifying patients who may benefit from adjuvant treatment after surgery.

New biomarkers have improved risk stratification in diagnosing and treating prostate cancer. Many of these markers are still considered experimental, and their efficacy and cost utility have not been determined.

Abdominal radiology (New York). 2019 Nov 13 [Epub ahead of print]

Amihay Nevo, Anojan Navaratnam, Paul Andrews

Department of Urology, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA. ., Department of Urology, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.