Presurgical Biomarker Performance in the Detection of Gleason Upgrading in Prostate Cancer

Gleason Score (GS) upgrading is generally considered a trigger for exit to definitive treatment during active surveillance (AS). Predicting the potential for GS upgrading would be of value in assessing AS eligibility. We assessed the performance of biomarkers in presurgical specimens of expressed prostatic secretion (EPS) in this setting. Although EPS volume, total recovered RNA, and RNA expression biomarkers (TMPRSS2: ERG, PCA3, PSA) have been successful in both biopsy outcome prediction, and in the prediction of upstaging in active surveillance eligible patients, they were unable to predict upgrading in patients eligible for active surveillance under National Comprehensive Cancer Network guidelines. These biomarkers do not improve the prediction of upgrading over indications from standard clinical parameters. Additional biomarkers will be needed in this area. Cancer Epidemiol Biomarkers Prev; 25(12); 1643-5. ©2016 AACR.