TY - JOUR
T1 - Prognostic Biomarkers Used for Localised Prostate Cancer Management
T2 - A Systematic Review
AU - Lamy, Pierre Jean
AU - Allory, Yves
AU - Gauchez, Anne Sophie
AU - Asselain, Bernard
AU - Beuzeboc, Philippe
AU - de Cremoux, Patricia
AU - Fontugne, Jacqueline
AU - Georges, Agnès
AU - Hennequin, Christophe
AU - Lehmann-Che, Jacqueline
AU - Massard, Christophe
AU - Millet, Ingrid
AU - Murez, Thibaut
AU - Schlageter, Marie Hélène
AU - Rouvière, Olivier
AU - Kassab-Chahmi, Diana
AU - Rozet, François
AU - Descotes, Jean Luc
AU - Rébillard, Xavier
N1 - Publisher Copyright:
© 2017 European Association of Urology
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Context: Prostate cancer stratification is based on tumour size, pretreatment PSA level, and Gleason score, but it remains imperfect. Current research focuses on the discovery and validation of novel prognostic biomarkers to improve the identification of patients at risk of aggressive cancer or of tumour relapse. Objective: This systematic review by the Intergroupe Coopérateur Francophone de Recherche en Onco-urologie (ICFuro) analysed new evidence on the analytical validity and clinical validity and utility of six prognostic biomarkers (PHI, 4Kscore, MiPS, GPS, Prolaris, Decipher). Evidence acquisition: All available data for the six biomarkers published between January 2002 and April 2015 were systematically searched and reviewed. The main endpoints were aggressive prostate cancer prediction, additional value compared to classical prognostic parameters, and clinical benefit for patients with localised prostate cancer. Evidence synthesis: The preanalytical and analytical validations were heterogeneous for all tests and often not adequate for the molecular signatures. Each biomarker was studied for specific indications (candidates for a first or second biopsy, and potential candidates for active surveillance, radical prostatectomy, or adjuvant treatment) for which the level of evidence (LOE) was variable. PHI and 4Kscore were the biomarkers with the highest LOE for discriminating aggressive and indolent tumours in different indications. Conclusions: Blood biomarkers (PHI and 4Kscore) have the highest LOE for the prediction of more aggressive prostate cancer and could help clinicians to manage patients with localised prostate cancer. The other biomarkers show a potential prognostic value; however, they should be evaluated in additional studies to confirm their clinical validity. Patient summary: We reviewed studies assessing the value of six prognostic biomarkers for prostate cancer. On the basis of the available evidence, some biomarkers could help in discriminating between aggressive and non-aggressive tumours with an additional value compared to the prognostic parameters currently used by clinicians.
AB - Context: Prostate cancer stratification is based on tumour size, pretreatment PSA level, and Gleason score, but it remains imperfect. Current research focuses on the discovery and validation of novel prognostic biomarkers to improve the identification of patients at risk of aggressive cancer or of tumour relapse. Objective: This systematic review by the Intergroupe Coopérateur Francophone de Recherche en Onco-urologie (ICFuro) analysed new evidence on the analytical validity and clinical validity and utility of six prognostic biomarkers (PHI, 4Kscore, MiPS, GPS, Prolaris, Decipher). Evidence acquisition: All available data for the six biomarkers published between January 2002 and April 2015 were systematically searched and reviewed. The main endpoints were aggressive prostate cancer prediction, additional value compared to classical prognostic parameters, and clinical benefit for patients with localised prostate cancer. Evidence synthesis: The preanalytical and analytical validations were heterogeneous for all tests and often not adequate for the molecular signatures. Each biomarker was studied for specific indications (candidates for a first or second biopsy, and potential candidates for active surveillance, radical prostatectomy, or adjuvant treatment) for which the level of evidence (LOE) was variable. PHI and 4Kscore were the biomarkers with the highest LOE for discriminating aggressive and indolent tumours in different indications. Conclusions: Blood biomarkers (PHI and 4Kscore) have the highest LOE for the prediction of more aggressive prostate cancer and could help clinicians to manage patients with localised prostate cancer. The other biomarkers show a potential prognostic value; however, they should be evaluated in additional studies to confirm their clinical validity. Patient summary: We reviewed studies assessing the value of six prognostic biomarkers for prostate cancer. On the basis of the available evidence, some biomarkers could help in discriminating between aggressive and non-aggressive tumours with an additional value compared to the prognostic parameters currently used by clinicians.
KW - Active surveillance
KW - Biomarkers
KW - Genomic signature
KW - Prognosis
KW - Prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85014556362&partnerID=8YFLogxK
U2 - 10.1016/j.euf.2017.02.017
DO - 10.1016/j.euf.2017.02.017
M3 - Review article
C2 - 28753865
AN - SCOPUS:85014556362
SN - 2405-4569
VL - 4
SP - 790
EP - 803
JO - European Urology Focus
JF - European Urology Focus
IS - 6
ER -