The Clinical Applications of Tissue Biomarkers in Prostate Cancer

The clinical course of localized prostate cancer varies widely, from indolent disease unlikely to need treatment to aggressive disease requiring intensive, multimodal therapy. Traditionally, treatment decisions have been based on clinical and pathologic factors, including serum prostate specific antigen (PSA), clinical stage, and Gleason score. However, these factors have limited ability to describe the underlying tumor biology. Tissue-based genomic tests have emerged as a promising tool to more accurately characterize prostate cancer biology and predict clinical course. Using prostate cancer tissue obtained at pre-treatment biopsy or radical prostatectomy, these tests exploit the expression of specific genes involved in key biological pathways and, as a result, have the potential to aid clinical decision-making. The current review summarizes available data describing the clinical use of 5 commercially available tissue-based genomic assays in a number of clinical scenarios.