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Contemporary Role of Prostate Cancer Antigen 3 in the Management of Prostate Cancer

Auprich, Marco; Bjartell, Anders LU ; Chun, Felix K. -H.; de la Taille, Alexandre; Freedland, Stephen J.; Haese, Alexander; Schalken, Jack; Stenzl, Arnulf; Tombal, Bertrand and van der Poel, Henk (2011) In European Urology 60(5). p.1045-1054
Abstract
Context: Newly discovered biomarkers ideally should prove clinical usefulness, provide additional detection, staging, and prognosis information to improve individual risk assessment, and potentially permit targeted cancer therapy. Objective: To review, display, and evaluate the current evidence regarding the biologic and analytic approach of urinary prostate cancer gene 3 (PCA3) in prostate cancer (PCa) detection, staging, and prognosis, and its therapeutic potential. Evidence acquisition: A systematic and comprehensive Medline search was performed using the Medical Subject Headings search terms PCA3, DD3, UPM3, prostate cancer, cell-lines, prostate tissue, prostate biopsy, detection, diagnosis, radical prostatectomy, staging, grading,... (More)
Context: Newly discovered biomarkers ideally should prove clinical usefulness, provide additional detection, staging, and prognosis information to improve individual risk assessment, and potentially permit targeted cancer therapy. Objective: To review, display, and evaluate the current evidence regarding the biologic and analytic approach of urinary prostate cancer gene 3 (PCA3) in prostate cancer (PCa) detection, staging, and prognosis, and its therapeutic potential. Evidence acquisition: A systematic and comprehensive Medline search was performed using the Medical Subject Headings search terms PCA3, DD3, UPM3, prostate cancer, cell-lines, prostate tissue, prostate biopsy, detection, diagnosis, radical prostatectomy, staging, grading, progression, and gene therapy. Results were restricted to English-language papers published within the period 1999-2011. Evidence synthesis: The PCA3 gene is highly overexpressed in specific PCa cell lines and prostatic tumours. In 2006, a simple and robust urine test (Progensa) became commercially available. Despite its costs, prostate cancer antigen 3 (PCA3) is superior to prostate-specific antigen (PSA) and percent free PSA in the early detection of PCa. PCA3 improves the diagnostic accuracy of externally validated nomograms among men with an elevated PSA undergoing biopsy. PCA3 independently predicts low-volume disease and pathologically insignificant PCa but is not associated with locally advanced disease and is limited in the prediction of aggressive cancer. Preliminary data demonstrate that combining PCA3 with other new biomarkers further improves diagnostic and prognostic accuracy. Finally, findings of the first PCA3-Gene-ViroTherapy study suggest therapeutic potential by exploiting PCA3 overexpression. Conclusions: PCA3, integrated in novel biopsy nomograms or risk stratification tools, can be used to counsel or confirm biopsy indications. If confirmed in further studies, using PCA3 together with established staging risk factors could assist clinicians in specific pretreatment decision making. So far no evidence for the usefulness of PCA3 in active surveillance programs has been presented. Published by Elsevier B. V. on behalf of European Association of Urology. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PCA3, Prostate biopsy, Prostate cancer detection, Staging, Targeted, therapy
in
European Urology
volume
60
issue
5
pages
1045 - 1054
publisher
Elsevier
external identifiers
  • wos:000296149400039
  • scopus:80053315206
ISSN
1873-7560
DOI
10.1016/j.eururo.2011.08.003
language
English
LU publication?
yes
id
9509f8e5-c7e1-4c7f-9d41-6b633e2d64b7 (old id 2208345)
date added to LUP
2011-12-01 08:26:36
date last changed
2017-10-29 03:49:00
@article{9509f8e5-c7e1-4c7f-9d41-6b633e2d64b7,
  abstract     = {Context: Newly discovered biomarkers ideally should prove clinical usefulness, provide additional detection, staging, and prognosis information to improve individual risk assessment, and potentially permit targeted cancer therapy. Objective: To review, display, and evaluate the current evidence regarding the biologic and analytic approach of urinary prostate cancer gene 3 (PCA3) in prostate cancer (PCa) detection, staging, and prognosis, and its therapeutic potential. Evidence acquisition: A systematic and comprehensive Medline search was performed using the Medical Subject Headings search terms PCA3, DD3, UPM3, prostate cancer, cell-lines, prostate tissue, prostate biopsy, detection, diagnosis, radical prostatectomy, staging, grading, progression, and gene therapy. Results were restricted to English-language papers published within the period 1999-2011. Evidence synthesis: The PCA3 gene is highly overexpressed in specific PCa cell lines and prostatic tumours. In 2006, a simple and robust urine test (Progensa) became commercially available. Despite its costs, prostate cancer antigen 3 (PCA3) is superior to prostate-specific antigen (PSA) and percent free PSA in the early detection of PCa. PCA3 improves the diagnostic accuracy of externally validated nomograms among men with an elevated PSA undergoing biopsy. PCA3 independently predicts low-volume disease and pathologically insignificant PCa but is not associated with locally advanced disease and is limited in the prediction of aggressive cancer. Preliminary data demonstrate that combining PCA3 with other new biomarkers further improves diagnostic and prognostic accuracy. Finally, findings of the first PCA3-Gene-ViroTherapy study suggest therapeutic potential by exploiting PCA3 overexpression. Conclusions: PCA3, integrated in novel biopsy nomograms or risk stratification tools, can be used to counsel or confirm biopsy indications. If confirmed in further studies, using PCA3 together with established staging risk factors could assist clinicians in specific pretreatment decision making. So far no evidence for the usefulness of PCA3 in active surveillance programs has been presented. Published by Elsevier B. V. on behalf of European Association of Urology.},
  author       = {Auprich, Marco and Bjartell, Anders and Chun, Felix K. -H. and de la Taille, Alexandre and Freedland, Stephen J. and Haese, Alexander and Schalken, Jack and Stenzl, Arnulf and Tombal, Bertrand and van der Poel, Henk},
  issn         = {1873-7560},
  keyword      = {PCA3,Prostate biopsy,Prostate cancer detection,Staging,Targeted,therapy},
  language     = {eng},
  number       = {5},
  pages        = {1045--1054},
  publisher    = {Elsevier},
  series       = {European Urology},
  title        = {Contemporary Role of Prostate Cancer Antigen 3 in the Management of Prostate Cancer},
  url          = {http://dx.doi.org/10.1016/j.eururo.2011.08.003},
  volume       = {60},
  year         = {2011},
}