Genomics and Biomarkers

Section Editor: Leonard G. Gomella, MD

The role of genetic testing for prostate cancer risk is a rapidly changing area. Experts debate the indications of sending a patient on to genetic counseling for further potential screening for inherited prostate cancer risk. One major issue that needs to be addressed in the urology community today is recognizing the frequency of inherited mutations that are affecting prostate cancer patients. About 1-2% of prostate cancer patients have mutations in BRCA 1 and 2, among a long list of other mutations that are quite common in metastatic prostate cancer. Evaluating inherited prostate cancer risk in patients should also be expanded to asking about family history in breast cancer, ovarian cancer, pancreatic cancer, and colon cancer. Genetic testing could be a way to catch prostate cancer early and improve patient outcomes.



Dr. Bryce & Dr. Crawford - Genomics & Biomarkers Prostate Cancer Risk Stratification

Point-Counterpoint: There is a Role for Currently Available Biomarkers/Genomics in the Risk Stratification of Prostate Cancer

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, and Alan H. Bryce, MD, Chair of the Division of Hematology and Medical Oncology and Assistant Professor of Medicine at the Mayo Clinic in Phoenix, Arizona, present a Point-Counterpoint on the relative value of genomics and biomarkers in prostate cancer risk stratification.


Drs. Shoskes, Porten, and Sfakianos - Use of the Cxbladder Monitor Urine Genomics Test for Surveillance of Patients with Non-Muscle-Invasive Bladder Cancerv

Use of the Cxbladder Monitor Urine Genomics Test for Surveillance of Patients with Non-Muscle-Invasive Bladder Cancer

Daniel Shoskes, MD; John P. Sfakianos, MD; and Sima P. Porten, MD, MPH; discuss the Cxbladder Monitor Test in surveillance of NMIBC patients.
Dr. Cooperberg - Updates in Prostate Cancer Biomarkers

Updates in Prostate Cancer Biomarkers

Matthew R. Cooperberg, MD, MPH, addresses updates in the use of biomarkers to assess risk for, and inform treatment of, prostate cancer.

Early Detection of Prostate Cancer: Navigating the Challenges in 2021

E. David Crawford, MD, discusses the challenges of early detection of prostate cancer and recommends a PSA cut-off of 1.5 ng/ml.

Updates of Changes in the Early Detection of Prostate Cancer NCCN Guidelines 2021

Preston C. Sprenkle, MD, outlines the 2021 National Comprehensive Cancer Network (NCCN) guidelines for prostate cancer early detection.
Dr. Weber - Genomic Sequencing & Genomic Classifiers

PCa Commentary | Volume 152 – April 2021

This Commentary provides a primer on using genomic classifiers and genomic sequencing to guide management decisions for prostate cancer.

Novel Combination of Circulating miRNAs for Specific Detection in Prostate Cancer

Fumihiko Urabe, MD, reviews a study he led investigating the potential of a collection of serum miRNA biomarkers as an accurate diagnostic method for PCa.

Prostate Cancer Genetic Testing: How to Hedge Bets in Selecting Patients for Surveillance, and When to Pull the Trigger on Treatment

Michael A. Brooks, MD, reviews the current evidence on the accuracy of multiparametric MRI fusion biopsy in biopsy-naïve patients and patients on active surveillance. He also discusses three commercially-available genomic tests, their validation using biopsy specimens, and performance in active surveillance cohorts.

Prevalence of Criteria for Genetic Testing According to the National Comprehensive Cancer Network Guidelines in a Contemporary Cohort of Post-Prostatectomy Men with Intermediate and High-Risk Prostate Cancer: The Henry Ford Health System Experience

Zade Roumayah details the results of a study at the Henry Ford Health System examining the prevalence of National Comprehensive Cancer Network criteria for genetic testing in post-prostatectomy men who had intermediate- to high-grade prostate cancer.

Evolving Intersection Between Inherited Cancer Genetics and Therapeutic Clinical Trials in Prostate Cancer

Neil F. Mariados, MD, describes the role of genetic mutations in the efficacy of prostate cancer treatment options and in the science behind poly (ADP-ribose) polymerase (PARP) inhibition. He also reviews clinical trials leading to PARP inhibitor research in prostate cancer and the many clinical trials investigating the intersection between cancer genetics and prostate cancer.
Next Generation Therapeutic Layering and Sequencing

FDUS 2018 – Next Generation Therapeutic Layering and Sequencing

Leonard G. Gomella, MD, FACS, led the “Next Generation Therapeutic Layering and Sequencing” session at the Future Directions in Urology Symposium (FDUS) 2018. These consensus statements represent a comprehensive analysis of current issues, challenges, and advancements in urology from a panel of international experts.
Biomarkers for Prostate Cancer

Biomarkers for Prostate Cancer: Whom to Treat

Gerald L. Andriole, Jr., MD, discusses the limitations and successes in the design of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and European Randomized Study of Screening for Prostate Cancer (ERSPC) trials. He also emphasizes the importance of patient selection in PSA screening and utilizing other diagnostic methods.
Basic Science in Bladder Cancer Diagnosis and Treatment

Basic Science Foundations of Bladder Cancer Diagnosis and Treatment

Dan Theodorescu, MD, PhD, describes scientific concepts underlying bladder cancer biology and the technologies, including biomarkers, PRC, and Western blots, that have enabled the formation of our knowledge today. He then explain how these concepts have and will be used in the clinical management of bladder cancer.



Leonard G. Gomella, MD
Thomas Jefferson University
Philadelphia, Pennsylvania 

Leonard Gomella, MD, is the Bernard W. Godwin, Jr. Professor of Prostate Cancer and Chairman of the Department of Urology at the Sidney Kimmel Medical College. He joined the Jefferson faculty in 1988 and was appointed Chair in 2002. He serves as Senior Director for Clinical Affairs for the NCI designated Sidney Kimmel Cancer Center at Jefferson, Clinical Director of the SKCC Network and Urology Chair for NRG (RTOG). Dr. Gomella is involved in translational basic science and clinical research in the development of new diagnostic techniques and treatments for prostate and bladder cancer through the Sidney Kimmel Cancer Center as Co-Leader of the Biology of Prostate Cancer Program. 

Supported in part by Myriad Genetics.