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Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline.

Publication ,  Journal Article
Eggener, SE; Rumble, RB; Armstrong, AJ; Morgan, TM; Crispino, T; Cornford, P; van der Kwast, T; Grignon, DJ; Rai, AJ; Agarwal, N; Klein, EA ...
Published in: J Clin Oncol
May 1, 2020

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: Oncotype 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.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 1, 2020

Volume

38

Issue

13

Start / End Page

1474 / 1494

Location

United States

Related Subject Headings

  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Practice Guidelines as Topic
  • Pathology, Molecular
  • Outcome Assessment, Health Care
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Humans
 

Citation

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Eggener, S. E., Rumble, R. B., Armstrong, A. J., Morgan, T. M., Crispino, T., Cornford, P., … Beltran, H. (2020). Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline. J Clin Oncol, 38(13), 1474–1494. https://doi.org/10.1200/JCO.19.02768
Eggener, Scott E., R Bryan Rumble, Andrew J. Armstrong, Todd M. Morgan, Tony Crispino, Philip Cornford, Theodorus van der Kwast, et al. “Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline.J Clin Oncol 38, no. 13 (May 1, 2020): 1474–94. https://doi.org/10.1200/JCO.19.02768.
Eggener SE, Rumble RB, Armstrong AJ, Morgan TM, Crispino T, Cornford P, et al. Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline. J Clin Oncol. 2020 May 1;38(13):1474–94.
Eggener, Scott E., et al. “Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline.J Clin Oncol, vol. 38, no. 13, May 2020, pp. 1474–94. Pubmed, doi:10.1200/JCO.19.02768.
Eggener SE, Rumble RB, Armstrong AJ, Morgan TM, Crispino T, Cornford P, van der Kwast T, Grignon DJ, Rai AJ, Agarwal N, Klein EA, Den RB, Beltran H. Molecular Biomarkers in Localized Prostate Cancer: ASCO Guideline. J Clin Oncol. 2020 May 1;38(13):1474–1494.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 1, 2020

Volume

38

Issue

13

Start / End Page

1474 / 1494

Location

United States

Related Subject Headings

  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Practice Guidelines as Topic
  • Pathology, Molecular
  • Outcome Assessment, Health Care
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Humans