Clinical proteomics for prostate cancer: understanding prostate cancer pathology and protein biomarkers for improved dis
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(2020) 17:41 Tonry et al. Clin Proteom https://doi.org/10.1186/s12014-020-09305-7
Open Access
REVIEW
Clinical proteomics for prostate cancer: understanding prostate cancer pathology and protein biomarkers for improved disease management Claire Tonry1, Stephen Finn2, John Armstrong3 and Stephen R. Pennington1*
Abstract Following the introduction of routine Prostate Specific Antigen (PSA) screening in the early 1990′s, Prostate Cancer (PCa) is often detected at an early stage. There are also a growing number of treatment options available and so the associated mortality rate is generally low. However, PCa is an extremely complex and heterogenous disease and many patients suffer disease recurrence following initial therapy. Disease recurrence commonly results in metastasis and metastatic PCa has an average survival rate of just 3–5 years. A significant problem in the clinical management of PCa is being able to differentiate between patients who will respond to standard therapies and those who may benefit from more aggressive intervention at an earlier stage. It is also acknowledged that for many men the disease is not life threatenting. Hence, there is a growing desire to identify patients who can be spared the significant side effects associated with PCa treatment until such time (if ever) their disease progresses to the point where treatment is required. To these important clinical needs, current biomarkers and clinical methods for patient stratification and personlised treatment are insufficient. This review provides a comprehensive overview of the complexities of PCa pathology and disease management. In this context it is possible to review current biomarkers and proteomic technologies that will support development of biomarker-driven decision tools to meet current important clinical needs. With such an indepth understanding of disease pathology, the development of novel clinical biomarkers can proceed in an efficient and effective manner, such that they have a better chance of improving patient outcomes. Keywords: Prostate cancer, Biomarkers, Proteomics, Disease pathology Background Prostate Cancer (PCa) is the second most common cancer diagnosed in men, and the fifth most common cause of cancer-associated death for males worldwide [1, 2]. Appropriate management of the disease is one of the biggest challenges associated with PCa. The majority of men diagnosed with PCa have indolent disease that can be safely managed without immediate treatment and will
*Correspondence: [email protected] 1 UCD Conway Institute, University College Dublin, Dublin, Ireland Full list of author information is available at the end of the article
likely not be threatening to their natural life expectancy. However, for some the disease will progress and spread (metastasise) to other sites beyond the prostate, at which point the prognosis for patients is much worse. Indeed only 28% of men diagnosed with metastatic PCa survive beyond 5 years [3, 4]. Although PSA remains the gold-standard biomarker for PCa diagnosis and is on
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