Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline
| Autor: | Alex J. Rai, Theodorus van der Kwast, David J. Grignon, Todd M. Morgan, Himisha Beltran, R. Bryan Rumble, Eric A. Klein, Scott E. Eggener, Andrew J. Armstrong, Robert B. Den, Tony Crispino, Philip Cornford, Neeraj Agarwal |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty 030232 urology & nephrology Outcome assessment 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine Outcome Assessment Health Care Biomarkers Tumor Humans Medicine Pathology Molecular Neoplasm Staging Prostatectomy business.industry Prostatic Neoplasms Guideline Prognosis medicine.disease Molecular biomarkers 030220 oncology & carcinogenesis Practice Guidelines as Topic business |
| Zdroj: | Journal of Clinical Oncology. 38:1474-1494 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.19.02768 |
| Popis: | PURPOSE This guideline provides recommendations for available tissue-based prostate cancer biomarkers geared toward patient selection for active surveillance, identification of clinically significant disease, choice of postprostatectomy adjuvant versus salvage radiotherapy, and to address emerging questions such as the relative value of tissue biomarkers compared with magnetic resonance imaging. METHODS An ASCO multidisciplinary Expert Panel, with representatives from the European Association of Urology, American Urological Association, and the College of American Pathologists, conducted a systematic literature review of localized prostate cancer biomarker studies between January 2013 and January 2019. Numerous tissue-based molecular biomarkers were evaluated for their prognostic capabilities and potential for improving management decisions. Here, the Panel makes recommendations regarding the clinical use and indications of these biomarkers. RESULTS Of 555 studies identified, 77 were selected for inclusion plus 32 additional references selected by the Expert Panel. Few biomarkers had rigorous testing involving multiple cohorts and only 5 of these tests are commercially available currently: Onco type Dx Prostate, Prolaris, Decipher, Decipher PORTOS, and ProMark. With various degrees of value and validation, multiple biomarkers have been shown to refine risk stratification and can be considered for select men to improve management decisions. There is a paucity of prospective studies assessing short- and long-term outcomes of patients when these markers are integrated into clinical decision making. RECOMMENDATIONS Tissue-based molecular biomarkers (evaluating the sample with the highest volume of the highest Gleason pattern) may improve risk stratification when added to standard clinical parameters, but the Expert Panel endorses their use only in situations in which the assay results, when considered as a whole with routine clinical factors, are likely to affect a clinical decision. These assays are not recommended for routine use as they have not been prospectively tested or shown to improve long-term outcomes—for example, quality of life, need for treatment, or survival. Additional information is available at www.asco.org/genitourinary-cancer-guidelines . |
| Databáze: | OpenAIRE |
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