Prostate cancer - a biomarker perspective

Abstract

Despite early detection and reduced risk of death, prostate cancer still remains the second leading cause of cancer death in American men. There is currently no cure for advanced prostate cancer. The multistage, stochastic and highly heterogeneous nature of prostate cancer, coupled with genetic and epigenetic alterations that occur during disease progression and response to therapy, represent fundamental challenges in our quest to understand and control this complex and prevalent disease. Recent advances in drug development and breakthroughs in omics technologies have renewed our efforts to identify novel biomarkers for prostate cancer prognosis, prediction, and therapeutic response monitoring. In this perspective article, we overview the current status and highlight future prospects of biomarkers for prostate cancer, a disease that affects millions of men worldwide.

Keywords: biomarker; personalized medicine; prostate cancer.

FIGURE 1

Types of biomarkers in prostate cancer prognosis, therapeutic response, and drug development. Biomarkers can be used to predict the natural course of a prostate disease (prognosis), help clinicians with decision making about the likelihood to respond to a given drug (predictive) and at what dose it might be most effective (pharmacodynamics). Red color denotes types of biomarker, blue color denotes the biomarker-based decision making, and green color indicates the exemplary actions or events. PSA, prostate-specific antigen; DRE, digital rectal examination; TRUS, transrectal ultrasound; PD biomarker, pharmacodynamic biomarker.

FIGURE 2

Black boxes denote conceptual breakthroughs, blue boxes denote biomarker advances, and green boxes denote therapeutic and technological outlook. PAP, prostatic acid phosphatase; PSA, prostate-specific antigen; FDA, US Food and Drug Administration; CTC, circulating tumor cells; NGS, next-generation sequencing; miRNA, microRNA.