What biomarkers impact prostate cancer care options? Expert Dr. Daniel Sentana Lledo, explains how predictive and prognostic biomarkers help assess risk, guide diagnosis, and support personalized prostate cancer treatment decisions.
Dr. Daniel Sentana Lledo is a genitourinary medical oncologist in the Lank Center for Genitourinary at Dana-Farber Cancer Institute. Learn more about Dr. Sentana Lledo.
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Transcript
Katherine Banwell:
What about biomarker testing, does that have a role in prostate cancer care?
Dr. Daniel Sentana Lledo:
Yes. So, in different ways. As I said, in a way, PSA is about the most reliable and most longitudinally valid biomarker we have.
So, while it’s not a great test for diagnosing prostate cancer, once you have prostate cancer, it is actually a very good biomarker for how your disease is doing, at least at in the beginning stages when the cancer is still responsive and driven by androgen signaling. There are other biomarkers out there that are gaining importance, I would say. So, there are both what we call predictive biomarkers and prognostic biomarkers. So, let me explain a little bit though.
So, predictive means is that we have a therapy that, based on this test finding, we know it could benefit you more than people that do not have this marker. So, I would say, generally speaking, those are things that are like mutations that we find in cancer or some other things that are intrinsic to your disease.
The second thing, prognostic, means based on these findings, we know that in general, people with these findings are more likely to do better or worse than others. And so, for example, we have some newer tests that are looking at many genes in a patient’s prostate cancer sample that gives us a sense of like, beyond the usual imaging and biopsy, can we better predict who’s going to do worse, who has a more aggressive cancer than other people?
So, I would say those are some of the things that are emerging. For the most part, science advances slowly. So, we find something and then you have to prove that it’s actually helpful in changing the way we manage prostate cancer, but certainly this is a very important field across oncology, but certainly in prostate cancer.