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Biomarcadores en el manejo del cáncer de próstata. ¿Hay algo nuevo?

Abstract:

INTRODUCTION: Prostate cancer (PCa) diagnosis cornerstone has been prostate-specific antigen levels during the past decades, with a worrisome overdiagnosis and overtreatment of non-clinically significant disease. These pitfalls have prompted the search for more accurate molecular and genetic tests such asgenetic biomarkers. These new assays allow the testing of serum, urine, or prostatic tissue for molecular and genetic signs of prostate cancer, and provide information regarding both diagnosis and prognosis. OBJECTIVE: This review summarizes the latest information regarding PCa biomarkers, and is designed to assist urologists with ordering and interpreting these tests for different patients. EVIDENCE ACQUISITION: A PubMed-based literature search was conducted up to June 2018. We selected the most recent and relevant original articles, clinical trials and reviews that have provided relevant information to guide biomarker use. EVIDENCE SYNTHESIS: In this review, we discuss 11 commercially available biomarker assays. Results of clinical validation studies are presented. CONCLUSIONS: The use of genetic PCa biomarkers has a unique role in screening, diagnosis, surveillance, risk stratification and treatment for this disease. It is important that providers be able to recommend the appropriate test for each individual patient and circumstance within the disease. In the present time, no biomarker can be recommended over another, and large-scale and multi-institutional studies are required to validate the efficacy and cost utility of these new technologies.