Skip to main content
SpringerLink
Log in

Utilizing Biomarkers in Patients with Prior Negative Prostate Biopsy

  • Chapter
  • First Online:
Prostate Cancer

Abstract

In the clinical scenario of a persistently elevated PSA with a prior negative biopsy, the aforementioned studies clearly demonstrate the additional predictive abilities of numerous biomarkers that add additional value above and beyond PSA combined with available clinical metrics. Future studies should focus specifically on the detection of high-grade prostate cancer, cost-effectiveness of widescale implementation, and incorporation of biomarkers into multinomial predictive tools or calculators. Additionally, although our patient was specifically interested in biomarkers, the emerging imaging platforms (e.g., multiparametric MRI) will need to be integrated within the biomarker domain with perhaps a low-cost biomarker serving as a trigger for advanced imaging as has been suggested by others. At this point for our patient, in alignment with established guidelines, we would recommend consideration of one of the biomarkers with particular attention to the high NPV for detection of prostate cancer at the next biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69:89–95.

    Article  Google Scholar 

  2. Strimbu K, Tavel JA. What are biomarkers? Curr Opin HIV AIDS. 2010;5:463–6.

    Article  Google Scholar 

  3. Thompson IM, et al. Assessing prostate cancer risk: results from the prostate cancer prevention trial. J Natl Cancer Inst. 2006;98:529–34.

    Article  Google Scholar 

  4. Roobol MJ, et al. A risk-based strategy improves prostate-specific antigen–driven detection of prostate cancer. Eur Urol. 2010;57:79–85.

    Article  Google Scholar 

  5. ElShafei A, et al. More favorable pathological outcomes in men with low risk prostate cancer diagnosed on repeat versus initial Transrectal ultrasound guided prostate biopsy. J Urol. 2016;195:1767–72.

    Article  Google Scholar 

  6. Carter HB, Pearson JD. Prostate-specific antigen velocity and repeated measures of prostate-specific antigen. Urol Clin North Am. 1997;24:333–8.

    Article  CAS  Google Scholar 

  7. Christensson A, Laurell C-B, Lilja H. Enzymatic activity of prostate-specific antigen and its reactions with extracellular serine proteinase inhibitors. Eur J Biochem. 1990;194:755–63.

    Article  CAS  Google Scholar 

  8. Christensson A, et al. Serum prostate specific antigen complexed to α1-antichymotrypsin as an indicator of prostate cancer. J Urol. 1993;150:100–5.

    Article  CAS  Google Scholar 

  9. Catalona WJ, et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA. 1998;279:1542–7.

    Article  CAS  Google Scholar 

  10. Partin AW, et al. Prospective evaluation of percent free-PSA and complexed-PSA for early detection of prostate cancer. Prostate Cancer Prostatic Dis. 1998;1:197–203.

    Article  CAS  Google Scholar 

  11. Ankerst DP, et al. Serial percent-free PSA in combination with PSA for population-based early detection of prostate cancer. J Urol. 2016;196:355–60.

    Article  Google Scholar 

  12. Catalona WJ, Beiser JA, Smith DS. Serum free prostate specific antigen and prostate specific antigen density measurements for predicting cancer in men with prior negative prostatic biopsies. J Urol. 1997;158:2162–7.

    Article  CAS  Google Scholar 

  13. Catalona WJ, et al. A multi-center study of [−2]pro-prostate-specific antigen (PSA) in Combination with PSA and free PSA for prostate cancer detection in the 2.0 to 10.0 ng/mL PSA range. J Urol. 2011;185:1650–5.

    Article  CAS  Google Scholar 

  14. Loeb S, et al. The prostate Health Index selectively identifies clinically significant prostate cancer. J Urol. 2015;193:1163–9.

    Article  Google Scholar 

  15. Loeb S, et al. Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer. BJU Int. 2017;120:61–8.

    Article  CAS  Google Scholar 

  16. Lazzeri M, et al. Serum Index test %[−2]proPSA and prostate Health Index are more accurate than prostate specific antigen and %fPSA in predicting a positive repeat prostate biopsy. J Urol. 2012;188:1137–43.

    Article  CAS  Google Scholar 

  17. Boegemann M, et al. The percentage of prostate-specific antigen (PSA) isoform [−2]proPSA and the prostate Health Index improve the diagnostic accuracy for clinically relevant prostate cancer at initial and repeat biopsy compared with total PSA and percentage free PSA in men aged ≤65 years. BJU Int. 2016;117:72–9.

    Article  CAS  Google Scholar 

  18. Vickers AJ, et al. A panel of kallikrein markers can reduce unnecessary biopsy for prostate cancer: data from the European randomized study of prostate cancer screening in Göteborg, Sweden. BMC Med. 2008;6:19.

    Article  Google Scholar 

  19. Vickers A, et al. Reducing unnecessary biopsy during prostate cancer screening using a four-Kallikrein panel: an independent replication. J Clin Oncol. 2010;28:2493–8.

    Article  Google Scholar 

  20. Parekh DJ, et al. A multi-institutional prospective trial in the USA confirms that the 4Kscore accurately identifies men with high-grade prostate cancer. Eur Urol. 2015;68:464–70.

    Article  Google Scholar 

  21. Bryant RJ, et al. Predicting high-grade cancer at ten-core prostate biopsy using four kallikrein markers measured in blood in the ProtecT study. J Natl Cancer Inst. 2015;107. https://doi.org/10.1093/jnci/djv095.

  22. Gupta A, et al. A four-kallikrein panel for the prediction of repeat prostate biopsy: data from the European randomized study of prostate cancer screening in Rotterdam, Netherlands. Br J Cancer. 2010;103:708–14.

    Article  CAS  Google Scholar 

  23. Nordström T, et al. Comparison between the four-kallikrein panel and prostate Health Index (PHI) for predicting prostate cancer. Eur Urol. 2015;68:139–46.

    Article  Google Scholar 

  24. Bussemakers MJG, et al. DD3: a new prostate-specific Gene, highly overexpressed in prostate cancer. Cancer Res. 1999;59:5975–9.

    CAS  PubMed  Google Scholar 

  25. Deras IL, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008;179:1587–92.

    Article  Google Scholar 

  26. Marks LS, et al. PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy. Urology. 2007;69:532–5.

    Article  Google Scholar 

  27. Haese A, et al. Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy. Eur Urol. 2008;54:1081–8.

    Article  Google Scholar 

  28. Aubin SMJ, et al. PCA3 molecular urine test for predicting repeat prostate biopsy outcome in populations at risk: validation in the placebo arm of the Dutasteride REDUCE trial. J Urol. 2010;184:1947–52.

    Article  Google Scholar 

  29. Gittelman MC, et al. PCA3 molecular urine test as a predictor of repeat prostate biopsy outcome in men with previous negative biopsies: a prospective multicenter clinical study. J Urol. 2013;190:64–9.

    Article  CAS  Google Scholar 

  30. Wei JT, et al. Can urinary PCA3 supplement PSA in the early detection of prostate cancer? J Clin Oncol. 2014;32:4066–72.

    Article  CAS  Google Scholar 

  31. Van Neste L, et al. The epigenetic promise for prostate cancer diagnosis. Prostate. 2012;72:1248–61.

    Article  Google Scholar 

  32. Stewart GD, et al. Clinical utility of an epigenetic assay to detect occult prostate cancer in histopathologically negative biopsies: results of the MATLOC study. J Urol. 2013;189:1110–6.

    Article  Google Scholar 

  33. Partin AW, et al. Clinical validation of an epigenetic assay to predict negative histopathological results in repeat prostate biopsies. J Urol. 2014;192:1081–7.

    Article  Google Scholar 

  34. Van Neste L, et al. Risk score predicts high-grade prostate cancer in DNA-methylation positive, histopathologically negative biopsies. Prostate. 2016;76:1078–87.

    Article  Google Scholar 

  35. European Association of Urology. Prostate Cancer. Uroweb. 2014. http://uroweb.org/guideline/prostate-cancer/#5. Accessed 11 Oct 2017.

  36. Carter HB, et al. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190:419–26.

    Article  Google Scholar 

  37. Leyten GHJM, et al. Value of PCA3 to predict biopsy outcome and its potential role in selecting patients for multiparametric MRI. Int J Mol Sci. 2013;14:11347–55.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Washington, Seattle, WA, USA

    James T. Kearns M.D. & Daniel W. Lin M.D.

  2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Daniel W. Lin M.D.

Authors
  1. James T. Kearns M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel W. Lin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James T. Kearns M.D. .

Editor information

Editors and Affiliations

  1. Department of Urologic Surgery and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Sam S. Chang

  2. Department of Urology, University of Oklahoma Medical Center, Oklahoma City, Oklahoma, USA

    Michael S. Cookson

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kearns, J.T., Lin, D.W. (2018). Utilizing Biomarkers in Patients with Prior Negative Prostate Biopsy. In: Chang, S., Cookson, M. (eds) Prostate Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-78646-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-78646-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78645-2

  • Online ISBN: 978-3-319-78646-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation