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Urine biomarkers in prostate cancer

Nature Reviews Urology volume 7, pages 101–109 (2010)Cite this article

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Abstract

The deficiencies of serum PSA as a prostate-cancer-specific diagnostic test are well recognized. Thus, the development of novel biomarkers for prostate cancer detection remains an important and exciting challenge. Noninvasive urine-based tests are particularly attractive candidates for large-scale screening protocols, and biomarker discovery programs using urine samples have emerged for detecting and predicting aggressiveness of prostate cancer. Some new biomarkers already outperform serum PSA in the diagnosis of this disease. Currently, the PCA3 (prostate cancer antigen 3) urine test is probably the best adjunct to serum PSA for predicting biopsy outcome, and has proven its clinical relevance by surpassing the predictive abilities of traditional serum biomarkers. New research methods are also emerging, and high-throughput technologies will facilitate high-dimensional biomarker discovery. Future approaches will probably integrate proteomic, transcriptomic and multiplex approaches to detect novel biomarkers, and aim to identify combinations of multiple biomarkers to optimize the detection of prostate cancer. In addition, an unmet need remains for markers that differentiate indolent from aggressive cancers, to better inform treatment decisions.

Key Points

  • During the past decade, biomarker discovery programs using urine samples have emerged for detecting and predicting aggressiveness of prostate cancer

  • Three groups of urinary markers can be considered: DNA-based, RNA-based, and protein-based markers

  • A growing body of data suggests that various markers, and particularly the combination of multiple markers, offer promise in this setting

  • One RNA marker, PCA3 (prostate cancer antigen 3), has progressed past the early phases of discovery and development and demonstrated clinical utility in multicenter studies

  • Future work will have to integrate proteomic, transcriptomic and multiplex approaches and aim to identify combinations of multiple biomarkers to optimize the detection of prostate cancer

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Figure 1: PCA3 versus PSA biomarkers for the diagnosis of prostate cancer.
Figure 2: The strong androgen-regulated TMPRSS2 gene transcriptional promoter becomes fused to the ERG gene to form an androgen-regulated TMPRSS2–ERG fusion gene (middle).
Figure 3: ROC curves for the diagnosis of prostate cancer using mRNA markers.

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  1. Department of Urology, INSERM U955 Eq07, APHP, CHU Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France

    Guillaume Ploussard & Alexandre de la Taille

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Ploussard, G., de la Taille, A. Urine biomarkers in prostate cancer. Nat Rev Urol 7, 101–109 (2010). https://doi.org/10.1038/nrurol.2009.261

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