Sanoj Punnen, MD, MAS, presented “Liquid Biomarkers and MRI in Prostate Cancer – Complementary?” during the 6th Global Summit on Precision Diagnosis and Treatment of Prostate Cancer on September 22, 2022.
How to cite: Punnen, Sanoj. “Liquid Biomarkers and MRI in Prostate Cancer – Complementary?” September 22, 2022. Accessed Dec 2024. https://grandroundsinurology.com/liquid-biomarkers-and-mri-in-prostate-cancer-complementary/
Liquid Biomarkers and MRI in Prostate Cancer – Complementary? Sponsored by Exosome Diagnostics – Summary
In this presentation, sponsored by Exosome Diagnostics, Sanoj Punnen, MD, MAS, Associate Professor in the Desai Sethi Urology Institute at the University of Miami Miller School of Medicine in Miami, FL, discusses liquid biomarkers and how these can integrate with magnetic resonance imaging (MRI) in prostate cancer diagnostics. He begins by reviewing the pros and cons of multiparametric MRI (mpMRI) versus biomarkers, pointing out that this need not be an either/or approach. Dr. Punnen displays data showing consistent MRI Prostate Imaging Reporting and Data System (PIRADS) scores alongside 4Kscores® and points out data showing that using both of these tests together outperforms using either one of them on their own. He illustrates that test strategies using MRI and biomarkers in conjunction can help avoid biopsies while missing very small percentages of GG2+ cancer. Dr. Punnen cites another study that examined various testing algorithms in terms of biopsies avoided and high-grade cancers missed. He then shifts to discussion of MRI and the development of a habitat risk scoring system that assigns regions of risk within the prostate. Dr. Punnen explains ongoing research that is studying the use of this system combined with biomarker testing. Dr. Punnen continues to a discussion of exosomes, which are released by all living cells into biofluids and can deliver molecules not normally secreted from cells. ExoDx has a robust pipeline for the isolation of extracellular vesicles (EV) from various biofluids whereby they can extract ribonucleic acid (RNA) and perform RNA sequencing for various RNA targets. He explains further studies of tissue-specific EV enrichment, displaying data on prostate-specific membrane antigen (PSMA) enriched EVs, and citing the potential for this type of data to be used in prostate cancer risk assessment. Dr. Punnen concludes by summarizing that MRI and biomarkers appear to be complementary, but the optimal sequence remains unclear and needs further study; EVs are secreted by all localized tumors and are easily extracted for biofluids; and the ExoDx platform has significant potential for various indications in this area.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Sanoj Punnen, MD, MAS, completed his medical school at Queen’s University and urology residency at the University of Toronto in Canada. He then completed a uro-oncology fellowship and Master’s in Clinical Research at the University of California, San Francisco. He is board-certified in both urology and uro-oncology. His primary research interest is in localized prostate cancer. Specifically, his work has evaluated imaging, molecular, and genomic markers that play a role in prostate cancer diagnosis and prognosis. He is also involved in outcomes and health service research on trends in the incidence and management of prostate cancer.
