Improving the Evaluation and Diagnosis of Clinically Significant Prostate Cancer in 2017

Overview

Journal Curr Opin Urol

Specialty Urology

Date 2017 Feb 22

PMID 28221219

Citations 11

Authors

Sigrid V Carlsson

Monique J Roobol

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To provide an overview of the current state of the evidence and highlight recent advances in the evaluation and diagnosis of clinically significant prostate cancer, focusing on biomarkers, risk calculators and multiparametric MRI (mpMRI).

Recent Findings: In 2017 there are numerous options to improve early detection as compared to a purely prostate-specific antigen (PSA)-based approach. All have strengths and drawbacks. In addition to repeating the PSA and performing clinical work-up (digital rectal examination and estimation of prostate volume), additional tests investigated in the initial biopsy setting are: %free PSA, Prostate Health Index, 4-kallikrein score, SelectMDx, and Michigan Prostate Score and in the repeat setting: %free PSA, Prostate Health Index, 4-kallikrein score, Prostate Cancer Antigen 3, and ConfirmMDx. Risk calculators are available for both biopsy settings and incorporate clinical data with, or without, biomarkers. mpMRI is an important diagnostic adjunct.

Summary: There are numerous tests available that can help increase the specificity of PSA, in the initial and repeat biopsy setting. All coincide with a small decrease in sensitivity of detecting high-grade cancer. Cost effectiveness is crucial. The way forward is a multivariable risk assessment on the basis of readily available clinical data, potentially with the addition of PSA subforms, preferably at low cost. MRI in the prediagnostic setting is promising, but is not ready for 'prime time'.

Citing Articles

GNL3 and PA2G4 as Prognostic Biomarkers in Prostate Cancer.

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Aquaporins as Prognostic Biomarker in Prostate Cancer.

Kushwaha P, Verma S, Gupta S Cancers (Basel). 2023; 15(2).

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SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study.

Maggi M, Del Giudice F, Falagario U, Cocci A, Russo G, DI Mauro M Cancers (Basel). 2021; 13(9).

PMID: 33922626 PMC: 8122883. DOI: 10.3390/cancers13092047.

Prospective assessment of two-gene urinary test with multiparametric magnetic resonance imaging of the prostate for men undergoing primary prostate biopsy.

Busetto G, Del Giudice F, Maggi M, De Marco F, Porreca A, Sperduti I World J Urol. 2020; 39(6):1869-1877.

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Development of Prostate Cancer Organoid Culture Models in Basic Medicine and Translational Research.

Elbadawy M, Abugomaa A, Yamawaki H, Usui T, Sasaki K Cancers (Basel). 2020; 12(4).

PMID: 32218271 PMC: 7226333. DOI: 10.3390/cancers12040777.

References

Catalona W, Partin A, Slawin K, Brawer M, Flanigan R, Patel A . Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA. 1998; 279(19):1542-7. DOI: 10.1001/jama.279.19.1542. View

Futterer J, Briganti A, De Visschere P, Emberton M, Giannarini G, Kirkham A . Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature. Eur Urol. 2015; 68(6):1045-53. DOI: 10.1016/j.eururo.2015.01.013. View

Feibus A, Sartor O, Moparty K, Chagin K, Kattan M, Ledet E . Clinical Use of PCA3 and TMPRSS2:ERG Urinary Biomarkers in African-American Men Undergoing Prostate Biopsy. J Urol. 2016; 196(4):1053-60. DOI: 10.1016/j.juro.2016.04.075. View

Moore C, Robertson N, Arsanious N, Middleton T, Villers A, Klotz L . Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol. 2012; 63(1):125-40. DOI: 10.1016/j.eururo.2012.06.004. View

Konety B, Zappala S, Parekh D, Osterhout D, Schock J, Chudler R . The 4Kscore® Test Reduces Prostate Biopsy Rates in Community and Academic Urology Practices. Rev Urol. 2016; 17(4):231-40. PMC: 4735670. View

Siddiqui M, Rais-Bahrami S, Turkbey B, George A, Rothwax J, Shakir N . Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA. 2015; 313(4):390-7. PMC: 4572575. DOI: 10.1001/jama.2014.17942. View

Vlaeminck-Guillem V, Ruffion A, Andre J, Devonec M, Paparel P . Urinary prostate cancer 3 test: toward the age of reason?. Urology. 2009; 75(2):447-53. DOI: 10.1016/j.urology.2009.03.046. View

Stewart G, Van Neste L, Delvenne P, Delree P, Delga A, Alan McNeill S . Clinical utility of an epigenetic assay to detect occult prostate cancer in histopathologically negative biopsies: results of the MATLOC study. J Urol. 2012; 189(3):1110-6. DOI: 10.1016/j.juro.2012.08.219. View

Lughezzani G, Lazzeri M, Haese A, McNicholas T, De La Taille A, Buffi N . Multicenter European external validation of a prostate health index-based nomogram for predicting prostate cancer at extended biopsy. Eur Urol. 2013; 66(5):906-12. DOI: 10.1016/j.eururo.2013.12.005. View

10.

de la Calle C, Patil D, Wei J, Scherr D, Sokoll L, Chan D . Multicenter Evaluation of the Prostate Health Index to Detect Aggressive Prostate Cancer in Biopsy Naïve Men. J Urol. 2015; 194(1):65-72. PMC: 4696043. DOI: 10.1016/j.juro.2015.01.091. View

11.

van Leeuwen P, Connolly D, Tammela T, Auvinen A, Kranse R, Roobol M . Balancing the harms and benefits of early detection of prostate cancer. Cancer. 2010; 116(20):4857-65. DOI: 10.1002/cncr.25474. View

12.

Schoots I . Omission of systematic transrectal ultrasound guided biopsy from the MRI targeted approach in men with previous negative prostate biopsy might still be premature. Ann Transl Med. 2016; 4(10):205. PMC: 4885902. DOI: 10.21037/atm.2016.03.53. View

13.

Gaudreau P, Stagg J, Soulieres D, Saad F . The Present and Future of Biomarkers in Prostate Cancer: Proteomics, Genomics, and Immunology Advancements. Biomark Cancer. 2016; 8(Suppl 2):15-33. PMC: 4859450. DOI: 10.4137/BIC.S31802. View

14.

Eklund M, Gronberg H, Nordstrom T . The STHLM3 prostate cancer diagnostic study: calibration, clarification, and comments. Nat Rev Clin Oncol. 2016; 13(6). DOI: 10.1038/nrclinonc.2016.80. View

15.

Loeb S, Lilja H, Vickers A . Beyond prostate-specific antigen: utilizing novel strategies to screen men for prostate cancer. Curr Opin Urol. 2016; 26(5):459-65. PMC: 5035435. DOI: 10.1097/MOU.0000000000000316. View

16.

Gronberg H, Adolfsson J, Aly M, Nordstrom T, Wiklund P, Brandberg Y . Prostate cancer screening in men aged 50-69 years (STHLM3): a prospective population-based diagnostic study. Lancet Oncol. 2015; 16(16):1667-76. DOI: 10.1016/S1470-2045(15)00361-7. View

17.

Carlsson S, Kattan M . Prostate cancer: Personalized risk - stratified screening or abandoning it altogether?. Nat Rev Clin Oncol. 2016; 13(3):140-2. DOI: 10.1038/nrclinonc.2016.11. View

18.

Bergdahl A, Wilderang U, Aus G, Carlsson S, Damber J, Franlund M . Role of Magnetic Resonance Imaging in Prostate Cancer Screening: A Pilot Study Within the Göteborg Randomised Screening Trial. Eur Urol. 2016; 70(4):566-573. PMC: 4958033. DOI: 10.1016/j.eururo.2015.12.006. View

19.

Roobol M, van Vugt H, Loeb S, Zhu X, Bul M, Bangma C . Prediction of prostate cancer risk: the role of prostate volume and digital rectal examination in the ERSPC risk calculators. Eur Urol. 2011; 61(3):577-83. DOI: 10.1016/j.eururo.2011.11.012. View

20.

Schroder F, Hugosson J, Roobol M, Tammela T, Zappa M, Nelen V . Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384(9959):2027-35. PMC: 4427906. DOI: 10.1016/S0140-6736(14)60525-0. View