Biomarkers may predict men needing PCa treatment

A blood test for certain forms of PSA and measurement of DNA content in biopsy tissue accurately predict which men with potentially non-lethal prostate cancers may eventually need treatment, say urologists from Johns Hopkins University, Baltimore.

"Our goal is to develop new biomarkers to select the right patients for the right therapy and know when the therapy should be delivered," said senior author Robert Veltri, PhD.

Dr. Veltri and colleagues evaluated 71 men enrolled in a Johns Hopkins proactive surveillance program to monitor their small, low-grade cancers. The first test used was the Prostate Health Index (phi), and the second examined biopsy tissue for the amount of DNA in cells.

Results showed that the phi was higher in 39 men whose annual biopsy showed worsening prostate cancer. Also in these men, abnormal DNA copies in cells from biopsied prostate tissue were over-expressed in cancerous areas as well as in adjacent non-cancerous areas. Median follow-up was approximately 3.5 years.

"There are no outward signs that these small prostate cancers may be progressing-men clinically feel the same, and physicians are not likely to detect it on conventional imaging scans," Dr. Veltri said. "We believe that close monitoring with the right biomarker tools may help to detect this shift in pathological stage."

Results from the study were published in BJU International (2010; 105:329-33).