Integrated Diagnostics (Radiogenomics) and Patient Selection and Monitoring for Active Surveillance, Surgical, and Radiation Treatment
Sanoj Punnen, MD, MAS, discusses the use and benefits of integrated diagnostics for monitoring prostate cancer during Active Surveillance (AS). He begins by noting that AS is becoming a popular treatment for a wide range of low-risk prostate cancers, thanks to more granular risk-stratification methods and an increasing clinical emphasis on lowering patient burden during treatment.
Dr. Punnen then discusses lowering the frequency of serial biopsies as a means of lowering patient burden during treatment. He explores studies which indicate that MRI and Gleason scoring alone are insufficient for monitoring prostate cancer progression.
Dr. Punnen concludes with an exploration of the ongoing Miami MRI-Guided Active Selection for Treatment of Prostate Cancer (MAST) trial examining the use of MRI, 4Kscore, and Decipher scores during AS. The data thus far indicates that MRI alone is not predictive of progression, and that clinicians should consider integrating other prognostic data into their AS treatment protocols.
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