A clinical practice guideline developed by an American Society of Clinical Oncology (ASCO) multidisciplinary expert panel provides recommendations on the use of molecular biomarker tests to guide management decisions for men with localized prostate cancer.
Published in the Journal of Clinical Oncology (Dec. 12, 2019 [Epub ahead of print]), the systematic review-based guideline was developed to consider the potential role of commercially available molecular biomarkers in the following areas: identifying patients likely to benefit from active surveillance, diagnosing clinically significant prostate cancer (cancer with the potential to ultimately cause symptoms or metastasize), and guiding the decision between postprostatectomy adjuvant or versus salvage radiation therapy. It also assessed the relative strengths and weakness of the genomics testing and magnetic resonance imaging (MRI) for identifying clinically significant prostate cancer.
Scott E. Eggener, MD, of the University of Chicago Medicine, Chicago, served as co-chair for the ASCO Guideline Expert Panel. Discussing the guideline with Urology Times, he said, “To my knowledge, this is the first sanctioned guideline from a national organization that addresses the role of molecular biomarker testing for localized prostate cancer. The guideline strongly discourages routine reflexive testing because the tests are expensive, have not been prospectively tested or shown to improve long-term outcomes, and the information provided will not directly influence patient decision making or the treatment plan for the majority of patients.”
He continued, “The guideline, however, identifies a select group of men, represented by those with higher-risk features for progression, for whom the biomarker testing may provide information that can be helpful when considered along with routine clinical factors to inform their choice between active surveillance and treatment.”