Department of Urology, IRCCS European Institute of Oncology (IEO), Milan, Italy.
Unit of Urology, Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Minerva Urol Nephrol. 2021 Aug;73(4):442-451. doi: 10.23736/S2724-6051.21.04098-4. Epub 2021 Mar 26.
Molecular heterogeneity and availability of different therapeutic strategies are relevant clinical features of prostate cancer. On this basis, there is an urgent need to identify prognostic and predictive biomarkers for an individualized therapeutic approach. In this context, researchers focused their attention on biomarkers able to discriminate potential life-threatening from organ-confined disease. Such biomarker could provide aid in clinical decision making, helping to choose the treatment which ensures the best results in terms of patient survival and quality of life. To address this need, many new laboratory tests have been proposed, with a clear tendency to use panels of combined biomarkers. In this review we evaluate current data on the application in clinical practice of the most promising laboratory tests: Phi, 4K score and Stockholm 3 as circulating biomarkers, Mi-prostate score, Exo DX Prostate and Select MD-X as urinary biomarkers, Confirm MDx, Oncotype Dx, Prolaris and Decipher as tissue biomarkers. In particular, the ability of these tests in the identification of clinically significant PCa and their potential use for precision medicine have been explored in this review.
分子异质性和不同治疗策略的可用性是前列腺癌的重要临床特征。在此基础上,迫切需要确定用于个体化治疗方法的预后和预测生物标志物。在这种情况下,研究人员将注意力集中在能够区分潜在危及生命和器官受限疾病的生物标志物上。此类生物标志物可以为临床决策提供帮助,有助于选择在患者生存和生活质量方面能取得最佳效果的治疗方法。为了满足这一需求,已经提出了许多新的实验室检测方法,显然倾向于使用联合生物标志物的组合。在本综述中,我们评估了目前在临床实践中应用最有前途的实验室检测方法的应用:Phi、4K 评分和 Stockholm 3 作为循环生物标志物,Mi-prostate 评分、Exo DX Prostate 和 Select MD-X 作为尿液生物标志物,Confirm MDx、Oncotype Dx、Prolaris 和 Decipher 作为组织生物标志物。特别是,在本综述中探讨了这些检测方法在识别临床上有意义的前列腺癌中的能力及其在精准医学中的潜在用途。