Prostate cancer stratification is based on tumour size, pretreatment PSA level, and Gleason score, but it remains imperfect. Current research focuses on the discovery and validation of novel prognostic biomarkers to improve the identification of patients at risk of aggressive cancer or of tumour relapse.
This systematic review by the Intergroupe Coopérateur Francophone de Recherche en Onco-urologie (ICFuro) analysed new evidence on the analytical validity and clinical validity and utility of six prognostic biomarkers (PHI, 4Kscore, MiPS, GPS, Prolaris, Decipher).
All available data for the six biomarkers published between January 2002 and April 2015 were systematically searched and reviewed. The main endpoints were aggressive prostate cancer prediction, additional value compared to classical prognostic parameters, and clinical benefit for patients with localised prostate cancer.
The preanalytical and analytical validations were heterogeneous for all tests and often not adequate for the molecular signatures. Each biomarker was studied for specific indications (candidates for a first or second biopsy, and potential candidates for active surveillance, radical prostatectomy, or adjuvant treatment) for which the level of evidence (LOE) was variable. PHI and 4Kscore were the biomarkers with the highest LOE for discriminating aggressive and indolent tumours in different indications.
Blood biomarkers (PHI and 4Kscore) have the highest LOE for the prediction of more aggressive prostate cancer and could help clinicians to manage patients with localised prostate cancer. The other biomarkers show a potential prognostic value; however, they should be evaluated in additional studies to confirm their clinical validity.
We reviewed studies assessing the value of six prognostic biomarkers for prostate cancer. On the basis of the available evidence, some biomarkers could help in discriminating between aggressive and non-aggressive tumours with an additional value compared to the prognostic parameters currently used by clinicians.
European urology focus. 2017 Mar 07 [Epub ahead of print]
Pierre-Jean Lamy, Yves Allory, Anne-Sophie Gauchez, Bernard Asselain, Philippe Beuzeboc, Patricia de Cremoux, Jacqueline Fontugne, Agnès Georges, Christophe Hennequin, Jacqueline Lehmann-Che, Christophe Massard, Ingrid Millet, Thibaut Murez, Marie-Hélène Schlageter, Olivier Rouvière, Diana Kassab-Chahmi, François Rozet, Jean-Luc Descotes, Xavier Rébillard
Institut Médical d'Analyse Génomique, Clinique BeauSoleil, Montpellier, France. Electronic address: ., Service de Pathologie, CHU Henri Mondor, Créteil, France., UMR-S INSERM 1039, Institut de Biologie et de Pathologie, CHU Grenoble, Grenoble, France., IR4M-UMR8081, Université Paris-Sud, Paris, France., Département Oncologie Médicale, Institut Curie, Paris, France., Hôpital Saint-Louis, Paris, France., CHU Henri Mondor, Créteil, France., Médecine Nucléaire, CHU Bordeaux, Bordeaux, France., Institut Gustave Roussy, Villejuif, France., Département d'Imagerie Médicale, CHU Lapeyronie, Montpellier, France., CHU Montpellier, Montpellier, France., Service de Biologie Cellulaire, Hôpital Saint-Louis, AP-HP, Paris, France., Department of Urinary and Vascular Radiology, Hospices Civils de Lyon, Hôpital Edouard Herriot-Université Lyon 1, Lyon, France., Intergroupe Coopérateur Francophone de Recherche en Onco-urologie, Paris, France., Institut Mutualiste Montsouris, Paris-Université Paris Descartes, Paris, France., CHU Grenoble, France., Service d'Urologie, Clinique BeauSoleil, Montpellier, France.