Clinical use of biomarker studies needed

15 March 2013

Prostate cancer experts yesterday highlighted the need to bridge the gap between research and the practical or clinical applications of advances achieved in genetics research and chemoprevention studies.

“Researchers more and more understand that it is difficult to translate even excellent basic research to the clinical lab. And even when that research gets to the clinical lab, the complexity and the costs of a test can limit the use of the test because now healthcare costs are going up very rapidly,” said Dr. Harry Rittenhouse who spoke yesterday on urinary PCA3 during the International Conference on Prostate Cancer Prevention 2013 with Consensus Conference on Chemoprevention of Prostate Cancer, a gathering of prostate cancer experts from both sides of the Atlantic.

“The consequences is that sometimes a test which is very useful can only be used for a small part of the population that knows about the test and who can afford it,” added Rittenhouse. Rittenhouse mentioned that for instance using the PCA3 test and TMPRSS-erg together requires other investigations that will look into the outcomes of combining the two test together.

A line-up of speakers from the US, the UK and Europe spoke on various issues such as prostate cancer research developments, advances in treatment strategies, updates on current management approaches and future prospects.
Co-sponsored by ISCaP, EAU, National Institutes of Health (USA), Cancer Research UK, Prostate Cancer UK and the AICR, the day-long conference will again resume today for a smaller discussion group, and panel members are expected to discuss the drafting of a consensus statement on PCa chemoprevention that will later be published.

One of the session chairmen, Prof. Powel Brown of M. D. Anderson Cancer Center in Houston, Texas (USA), said the consensus statement will focus on the possible preventive strategies both behavioral or dietary preventions as well as medical preventions such as drugs to prevent prostate cancer. “Each of these issues will be addressed and hopefully we will come up with some consensus statements in early detection, prognostic biomarkers to predict high grade disease and the most appropriate clinical preventions,” Brown said. Brown added that he hopes to see a strong message on the use of biomarkers for prognostic stratification of PCa into low and high risk disease.
In a panel discussion, that speakers also discussed current policies for prostate cancer screening  and chemoprevention and share insights on the current debate whether PSA screening leads to more harms and benefits.

Earlier, Prof. Fritz Schroder reiterated his stand that screening for PCa reduces mortality. “Screening for prostate cancer significantly reduces  its mortality. Harms and their weight are identified and quantified. They do not exceed benefits,” said Schroder as he added that reducing the most important drawback such as over diagnosis and over treatment is “a top priority for clinicians.”
Prof. Gerald Andriole of Washington University, however, said the US experience did not indicate benefit. “There is no benefit of organized versus opportunistic screening,” he said.

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