Prostate Cancer Markers/Surveillance
Developments in markers for prostate cancer and active surveillance for men with low-risk disease continue to be major topics at the AUA annual meeting, says Stacy Loeb MD, MSc, assistant professor of urology and population health at New York University Langone and the Manhattan VA, New York.
“Several new serum and urine markers are being presented for use in prostate cancer diagnosis and prognostication. For men with prostate cancer, multiple studies look at the use of genomic tissue tests (eg, Prolaris, Oncotype Dx, and Decipher) to improve patient selection for upfront treatment versus active surveillance, or for decisions about secondary therapy,” she said.
Other major biomarker-related themes are the utility of commercially available markers in African-American men, the incremental value of marker tests in the context of multiparametric MRI, and the role of markers in advanced disease.
While active surveillance is now the recommended management option for most men with low-risk prostate cancer, some studies suggest that it remains underutilized in the United States, Dr. Loeb pointed out.
“Correspondingly, several studies attempt to define potential barriers to surveillance among health care providers and patients, such as the risk of prostate biopsy complications,” she said. “For men who choose active surveillance, look out for numerous studies on the role of MRI during follow-up and what is the optimal biopsy protocol to use.”
Specifically, Dr. Loeb pointed to these abstracts in the area of prostate cancer markers/surveillance:
MP28-11: Impact of the 17-gene panel on active surveillance persistence in contemporary urologic practices: An interim analysis in an observational cohort
PD28-03: Correlation between a genomics test and adverse pathology after radical prostatectomy among active surveillance candidates
MP43-03: Do prostate biopsy-associated complications influence treatment selection for patients with newly diagnosed, clinically localized prostate cancer?
MP43-20: Rates of non-definitive management for low and intermediate risk prostate cancer are similar between African Americans and Caucasians
PD71-01: Decipher test impacts decision-making among patients considering adjuvant and salvage treatment following radical prostatectomy: interim results from the multicenter prospective pro-impact study
John L. Gore
PD28-06: Variation in the use of active surveillance for low-risk prostate cancer
PD28-07: Tracking of prior positive sites by mri/us fusion improves detection of gleason score upgrading
PD28-09: Does MRI-fusion prostate biopsy improve risk reclassification for patients with prostate cancer on active surveillance compared to transrectal ultrasound-guided saturation biopsy
Ahmed El Shafei