How Can Phenotypic Biomarkers Increase the Use of Precision Medicine in Advanced Prostate Cancer?
A. Oliver Sartor, MD
Dr. Sartor explores how phenotypic biomarkers, which can be detected through noninvasive diagnostics such as prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging, are emerging as a novel approach to facilitate decision making in advanced prostate cancer.
Phenotypic precision medicine may facilitate decision making based on observable characteristics that are produced through the interaction of a genotype and environment.1-8 Phenotypes can be assessed through noninvasive diagnostics, such as PSMA PET/computed tomography (CT) imaging.4,9
In contrast, the analysis of genotypes requires the collection of biologic samples, which can be complicated to do in advanced prostate cancer.10
Limitations of prostate cancer biopsies include…
To overcome these challenges in prostate cancer, phenotypic biomarkers can be characterized through noninvasive diagnostics such as PET imaging.9,14,15
PET imaging leverages radiotracers to visualize cancer tissue at a high sensitivity and specificity.16
Commonly used radiotracers include…
CT, computed tomography; FDA, US Food and Drug Administration; 18F-FDG, 18fluorodeoxyglucose; NCCN, National Comprehensive Cancer Network; PET, positron emission tomography; PSA, prostate-specific antigen; PSMA, prostate-specific membrane antigen.
aIn a meta-analysis of the diagnostic performance of 11C-choline carried out on 8 selected studies including 276 patients.22
bIn a head-to-head comparison performed in 50 patients radically treated for prostate cancer and presenting with rising PSA levels.25
cIn a prospective, single-center, open-label comparative study, 50 adults with biochemical recurrence after radical prostatectomy and PSA levels <2 ng/mL.27
PSMA PET/CT imaging is a noninvasive diagnostic that can detect phenotypic biomarkers, such as PSMA, that may simplify your approach to precision medicine.1-3,5-7,14,15
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