Personalized medicine and prostate cancer. The reality of change - Abstract

Prostate cancer (PCa) is a public health problem in western male populations on the basis of it's high incidence and prevalence.

Nowadays we come to changes in the diagnostic technologies that deserve special attention and that once applied allow to show the way towards a personalized view of PCa being able to join this modern current trend of the oncologic pathology. In spite of the recognized heterogeneity of the disease; clinical, pathological and genetic variants in genes and the limitations of the PSA as a biomarker to determine the biological aggressiveness of PCa, the certain thing is that the therapeutic final decision is adopted on the basis of a distant information to the wished customization and it moves excessive uncertainty for patients.In this respect the search based on the identification of alterations on the genomic sequence and it's influence in the molecular characterization of the PCa is a constant in the investigation since nowadays. Actually, the progressive adjournment to the clinic of information tumour information that comes from the diagnostic tests related genetic material or their biochemical products, though still in initial phase, already allows to predict relevant changes in molecular characterization of the prostate cancer, in the eventual availability of predictive biomarkers from susceptibility to suffer the disease and of the personalized stratification of risk across the incorporation of newly and interesting molecular and immunohistochemistry biomarkers. Likewise the advances in the perspectives opened with the diagnosis, and the relevance in the decisions of biopsy indications that stem from it are based on the utilization, with the corresponding merger of images, of the multiparametric magnetic resonance (mpMRI) and the new prostate ecographic transrectal images with it's natural evolution towards focal treatments represent, in spite of the recognized complex interpretation of the images, another significant transformation towards the individualization and ideally customization of the clinical decisions opposite to a certain patient with PCa. Events all of them, even more, if they are considered to be combined turn out to be very promising and it's integration brings us over to personalized medicine in PCa since already it happens in others, though still small, neoplastic diseases. All this aspects are summarized and discussed in the present article in the light of the recent communicated information and the reflection and personal experience of the authors. Finally chasing how to improve the clinical managing and the treatment for patients with PCa.

Written by:
Carballido Rodríguez JA, Martínez-Salamanca JI.   Are you the author?
Servicio y Catedra de Urología, Hospital Universitario "Puerta de Hierro", Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España.

Reference: Arch Esp Urol. 2015 Apr;68(3):391-400.

PubMed Abstract
PMID: 25948808

Article in Spanish. Prostate Cancer Section