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Current Opinion in Urology Nov 2019To provide a comprehensive review of the available biomarkers for the detection and active surveillance of prostate cancer and simplify decision-making while choosing... (Review)
Review
PURPOSE OF REVIEW
To provide a comprehensive review of the available biomarkers for the detection and active surveillance of prostate cancer and simplify decision-making while choosing between them.
RECENT FINDINGS
The limitations of PSA and mpMRI and the invasive nature of prostate biopsy has led to a constant search for serum and urinary biomarkers for both the detection and monitoring during active surveillance of prostate cancer. 4K, PHI and PCA3 have been validated in prospective clinical trials for initial detection of prostate cancer and recent evidence points to potential differentiation between indolent and aggressive cancer. However, the usage in monitoring tumor dynamics is debatable because of lack of conclusive evidence. The answer to the existing problems lies in high-quality studies to establish definitive evidence and also to help choose between the plethora of biomarkers available today.
SUMMARY
Despite the advancements in innovation and usage of biomarkers in prostate cancer, there exists tremendous potential in improving them to fulfil the unmet need that exists today. Studies to establish conclusive evidence and integration with imaging can tremendously aid diagnosis and monitoring.
Topics: Antigens, Neoplasm; Biomarkers, Tumor; Humans; Male; Prostatic Neoplasms; Watchful Waiting
PubMed: 31436568
DOI: 10.1097/MOU.0000000000000670 -
Andrology Mar 2021Gaining insight into microRNAs (miRNAs) and genes that regulate the therapeutic response of cancer diseases in general and prostate cancer (PCa) in particular is an... (Review)
Review
BACKGROUND
Gaining insight into microRNAs (miRNAs) and genes that regulate the therapeutic response of cancer diseases in general and prostate cancer (PCa) in particular is an important issue in current molecular biomedicine and allows the discovery of predictive miRNA targets.
OBJECTIVES
The aim of this study was to analyze the available data on the influence of radiotherapy (RT) on miRNA expression and on miRNA involved in radiotherapy response in PCa.
MATERIALS AND METHODS
The data used in this review were extracted from research papers and the DIANA, STRING, and other databases with a special focus on the mechanisms of radiotherapy PCa response and the miRNA involved and associated genes.
RESULTS AND DISCUSSION
A search for miRNA prognostic and therapeutic effectiveness markers should rely on both the data of recent experimental studies on the influence of RT on miRNA expression and miRNAs involved in regulation of radiosensitivity in PCa and on bioinformatics resources. miRNA panels and genes targeted by them and involved in radioresponse regulation highlighted by meta-analysis and cross-analysis of the data in the present review have.
CONCLUSION
Selected miRNA and gene panel has good potential as prognostic and radiotherapy effectiveness markers for PCa and, moreover, as radiotherapy effectiveness markers in other types of cancer, as the proposed model is not specific to PCa, which opens up opportunities for the development of a universal diagnostic system (or several intersecting systems) for oncology radiotherapy in general.
Topics: Animals; Biomarkers, Tumor; Gene Expression Regulation, Neoplastic; Humans; Male; MicroRNAs; Prostatic Neoplasms; RNA, Neoplasm; Radiation Tolerance
PubMed: 33053272
DOI: 10.1111/andr.12921 -
European Urology Apr 2022New imaging techniques are more sensitive in prostate cancer and reveal sites of disease that may never have been seen with conventional imaging, resulting in stage...
New imaging techniques are more sensitive in prostate cancer and reveal sites of disease that may never have been seen with conventional imaging, resulting in stage migration and potentially a change in the clinical management. Until long-term data provide a better understanding of the natural history of the disease defined by more sensitive imaging, patients and clinicians should recognise the considerable uncertainty about whether these improve outcomes. It is hoped that the next iteration of the TNM classification will recognise the problem in some way.
Topics: Humans; Male; Neoplasm Staging; Prostatic Neoplasms
PubMed: 35094898
DOI: 10.1016/j.eururo.2022.01.002 -
Current Opinion in Oncology May 2020Summarize recent advances in the treatment of advanced prostate cancer. (Review)
Review
PURPOSE OF REVIEW
Summarize recent advances in the treatment of advanced prostate cancer.
RECENT FINDINGS
Recent randomized data suggest a survival advantage to early use of novel androgen receptor inhibitors in combination with androgen deprivation therapy both in the setting of hormone-sensitive metastatic prostate cancer and nonmetastatic castration-resistant disease. While ongoing analyses examine optimal sequencing of existing agents for treatment of advanced prostate cancer, additional research focuses on expanding treatment options through development of novel genomically targeted therapies, antibody-drug conjugates, and immune therapy combinations.
SUMMARY
In this review, we summarize the recent data supporting the early use of novel androgen receptor inhibitors in advanced prostate cancer and aim to also frame how these drugs may fit within the existing context of docetaxel and abiraterone. We present recent series examining sequencing of approved therapies while searching for predictive biomarkers. Finally, we examine trials evaluating novel agents that target certain biological pathways to highlight the likely future directions for progress in the clinical management of advanced prostate cancer.
Topics: Androgen Receptor Antagonists; Humans; Immunotherapy; Male; Molecular Targeted Therapy; Neoplasm Metastasis; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Radiopharmaceuticals; Randomized Controlled Trials as Topic
PubMed: 32209821
DOI: 10.1097/CCO.0000000000000624 -
Prostate Cancer and Prostatic Diseases Sep 2019Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal... (Review)
Review
BACKGROUND
Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication.
METHODS
We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer.
RESULTS
There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests.
CONCLUSIONS
Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.
Topics: Biomarkers, Tumor; Disease Progression; Early Detection of Cancer; Humans; Male; Mass Screening; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Prostate; Prostatic Neoplasms
PubMed: 30655600
DOI: 10.1038/s41391-019-0127-4 -
Cancer Letters Jan 2022Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in western countries. Androgen deprivation therapy... (Review)
Review
Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in western countries. Androgen deprivation therapy (ADT) is considered the standard therapy for recurrent prostate cancer; however, this therapy may lead to ADT resistance and tumor progression, which seems to be regulated by epithelial-mesenchymal transition (EMT) and/or neuroendocrine differentiation (NED). In addition, recent data suggested the involvement of either adaptive or innate infiltrated immune cells in the initiation, progression, metastasis, and treatment of prostate cancer. In this review, we outlined the characteristics and roles of these immune cells in the initiation, progression, metastasis, and treatments of prostate cancer. We also summarized the current therapeutic strategies in targeting immune cells of the prostate tumor microenvironment.
Topics: Androgen Antagonists; Androgens; Disease Progression; Drug Resistance, Neoplasm; Epithelial-Mesenchymal Transition; Humans; Male; Neoplasm Metastasis; Prostate; Prostatic Neoplasms; Tumor Microenvironment
PubMed: 34715253
DOI: 10.1016/j.canlet.2021.10.027 -
Urology Sep 2021Intraductal cribriform (IDC) and invasive cribriform morphologies are associated with worse prostate cancer outcomes. Limited retrospective studies have associated IDC... (Review)
Review
Intraductal cribriform (IDC) and invasive cribriform morphologies are associated with worse prostate cancer outcomes. Limited retrospective studies have associated IDC and cribriform morphology with germline mutations in DNA repair genes, particularly BRCA2. These findings, which prompted the National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer and Genetic/Familial High- Risk Assessment to consider germline testing for individuals with IDC/cribriform histology, have been questioned in a recent prospective study. A deepened understanding of the molecular mechanisms driving disease aggressiveness in cribriform morphology is critical to provide more clarity in clinical decision making. This review summarizes the current understanding of IDC and cribriform prostate cancer, with an emphasis on clinical outcomes and molecular alterations.
Topics: Humans; Male; Molecular Diagnostic Techniques; Neoplasm Grading; Prostatic Neoplasms
PubMed: 34058243
DOI: 10.1016/j.urology.2021.05.028 -
Urologia Feb 2020Prostate cancer is the most frequent non-cutaneous malignancy in men in the United States. In the last few years, many recommendations have been made available from the... (Review)
Review
Prostate cancer is the most frequent non-cutaneous malignancy in men in the United States. In the last few years, many recommendations have been made available from the 2014 International Society of Urologic Pathology consensus conference, 2016 World Health Organization blue book and 2018 8th edition of American Joint Committee on Cancer Staging System. Here, we focus on four topics which are considered relevant on the basis of their common appearance in routine practice, clinical importance and 'need to improve communication between pathology reports and clinicians': prostate cancer classification, prostate cancer grading, prostate cancer staging, and current definition of clinically significant prostate cancer. Tissue biomarkers that can predict significant disease and/or upgrading and tissue-based genomics for the purpose of diagnosis and prognosis are mentioned briefly.
Topics: Humans; Male; Neoplasm Grading; Neoplasm Staging; Prostatic Neoplasms; Time Factors
PubMed: 31545701
DOI: 10.1177/0391560319876821 -
Archivos Espanoles de Urologia Nov 2023Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer... (Review)
Review
Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as /, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy.
Topics: Male; Humans; Prostate; BRCA1 Protein; BRCA2 Protein; Prostatic Neoplasms; Biopsy; Carcinoma, Intraductal, Noninfiltrating; Neoplasm Grading
PubMed: 38053418
DOI: 10.56434/j.arch.esp.urol.20237609.78 -
The Urologic Clinics of North America Nov 2020Cancer vaccines, cytokines, and checkpoint inhibitors are immunotherapeutic agents that act within the cancer immunity cycle. Prostate cancer has provided unique... (Review)
Review
Cancer vaccines, cytokines, and checkpoint inhibitors are immunotherapeutic agents that act within the cancer immunity cycle. Prostate cancer has provided unique opportunities for, and challenges to, immunotherapy drug development, including low tumor mutational burdens, limited expression of PD-L1, and minimal T-cell intratumoral infiltrates. Nevertheless, efforts are ongoing to help prime prostate tumors by turning a "cold" prostate cancer "hot" and thus rendering them more susceptible to immunotherapy. Combination treatments, use of molecular biomarkers, and use of new immunotherapeutic agents provide opportunities to enhance the immune response to prostate tumors.
Topics: Aged; Biomarkers, Tumor; Cancer Vaccines; Humans; Immunologic Factors; Immunotherapy; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Prostatic Neoplasms; Risk Assessment; Survival Analysis; Treatment Outcome
PubMed: 33008495
DOI: 10.1016/j.ucl.2020.07.008