Two-Part Series to Explore Use of Biomarkers in GU Cancer Treatment

Raoul S. Concepcion, MD

When it comes to the personalized treatment of genitourinary cancers, biomarkers hold an immense amount of promise. Already, there are predictive and prognostic tools available to urologists.

In prostate cancer, either the old standby—prostate-specific antigen (PSA) testing—or the newer Prostate Health Index can help urologists determine when to biopsy a patient. When it seems a rebiopsy might be called for, doctors can use the ConfirmMDx test, which looks at DNA methylation; or, they can turn to PCA3, a urine test. Available to help urologists determine whom to treat are two additional tests: Prolaris and Oncotype DX.

But a host of new contenders are in development—in prostate cancer, so many that it can be difficult to keep track of all the tools and remember their specific indications. New tests are emerging in the pipeline for bladder, renal, and testicular cancers, as well, and urologists need to know the different options and how and when they should be used.

That’s why Urologists in Cancer Care has planned a two-part series exploring the use of biomarkers in the treatment of genitourinary cancers. To be published in the August and October issues of the magazine, the series will look at predictive and prognostic tests for all stages of prostate, bladder, renal, and testicular cancers, including tools already in use and others in development.

Our coverage will include the views of a variety of key opinion leaders on the promise of this burgeoning research pathway.

“There’s going to be testing that’s better than PSA to determine who needs a biopsy,” predicted Raoul S. Concepcion, MD, of Urology Associates in Nashville, Tennessee, and editor-in-chief of Urologists in Cancer Care. “If a biopsy shows a patient has cancer, then there will be testing to determine whether or not it’s aggressive, to predict who needs treatment and who is at risk of death. There will also be testing around a negative initial biopsy to see who gets rebiopsied, and then there will be a fourth category of tests to monitor the success of therapy.”

In the August issue, we will bring you a comprehensive article on available biomarker tests, as well as tests under development, specifically in prostate cancer. We will also present a summary of a recent OncLive TV Peer Exchange moderated by Dr. Concepcion, during which a panel of physicians discussed issues in metastatic castration-resistant prostate cancer, including the development and use of biomarker-based tools.

In October, we will follow that coverage with a definitive article about the current state of biomarker tools—both available and investigational—in bladder, renal cell, and testicular cancers. Also in that issue, we will offer an article exploring the challenges anticipated in obtaining health-insurance reimbursement for biomarker tests.

Dr. Concepcion hopes that the series on biomarkers will serve as a comprehensive guide for urologists on the use of prognostic and predictive tools.

“We see this as an opportunity to provide a thorough overview of what is available now, and what might be available in the next few years, when it comes to biomarker-based tools for prediction and prognostication in genitourinary cancers,” Dr. Concepcion said. “We hope physicians will read it, understand it, and keep it as a reference.”