Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Oncology, Clínica Santa María, 500 Santa Maria Street, 7500000, Santiago, Chile.
Curr Treat Options Oncol. 2018 Feb 8;19(2):8. doi: 10.1007/s11864-018-0527-z.
Clinical outcomes in prostate cancer after initial screening and treatment for organ-confined disease and in advanced stage after drug intervention can be heterogeneous. Serum prostate-specific antigen which has a modest value as a screening biomarker while widely used in practice in all subsequent stages has limitations for prognostication or prediction of drug efficacy. Recent advances in genomic sciences and the identification of the mutational landscape of organ-confined and advanced-stage disease have contributed to the development of molecular biomarker profiling in addition to serum prostate-specific antigen. Genomic biomarkers are in development for application to screening for lethal disease subtypes, monitoring of disease recurrence after initial treatments, prognostication, as well as for prediction of drug efficacy. The application of translational molecular profiling in prostate cancer has the potential to enhance clinical management and outcomes in the future. Molecular biomarkers in development in organ-confined disease include both DNA- and RNA-based candidate and pathway-based biomarkers. In advanced-stage disease, molecular biomarker profiling has emerged for identifying therapeutic targets, prediction of drug efficacy, and for prognostication of survival that includes germline single nucleotide profiling and somatic aberrations including copy number variation and mutations and RNA-based profiling. This review summarizes the current state of clinical biomarkers used in practice, their limitations, and novel molecular biomarkers being developed for several clinical endpoints in early- and late-stage cancer.
前列腺癌患者在初始筛查和针对局限性疾病的治疗后以及在药物干预后的晚期阶段的临床结局可能存在异质性。前列腺特异性抗原（PSA）作为一种具有中等价值的筛查生物标志物，尽管在实践中广泛应用于所有后续阶段，但在预测预后或药物疗效方面存在局限性。最近基因组科学的进展以及对局限性和晚期疾病的突变景观的鉴定，除了 PSA 外，还促进了分子生物标志物谱的发展。正在开发基因组生物标志物，以应用于致命疾病亚型的筛查、初始治疗后疾病复发的监测、预后以及药物疗效的预测。在前列腺癌中应用转化分子谱分析有可能在未来增强临床管理和结局。局限性疾病中正在开发的分子生物标志物包括基于 DNA 和 RNA 的候选标志物和基于途径的标志物。在晚期疾病中，分子生物标志物谱分析已用于确定治疗靶点、预测药物疗效和预测生存预后，包括种系单核苷酸谱分析和体细胞异常，包括拷贝数变异和突变以及基于 RNA 的谱分析。这篇综述总结了目前在实践中使用的临床生物标志物的现状、它们的局限性以及正在为早期和晚期癌症的几个临床终点开发的新型分子生物标志物。
