How to Integrate Prostate Cancer Biomarkers in Urology Clinical Practice: An Update

Simple Summary The management of prostate cancer becomes more and more challenging mainly due to limitations of risk stratifications systems and its heterogenous clinical and biological behavior. Therefore, to increase detection rate of clinically significant prostate cancer and to assess the aggressiveness of the disease is a clinical priority in daily urology practice. Several biomarkers have been developed over the last decade to improve the accuracy of serum PSA and to help clinicians in difficult management scenarios. In this review article, we focus on the scientific evidence that supports the clinical use of the most robust and reliable biomarkers considered by professional urological societies (and included in uro-oncological guidelines) in the early diagnosis process and treatment decisions for clinically localized or advanced prostate cancer.Abstract Nowadays, the management of prostate cancer has become more and more challenging due to the increasing number of available treatment options, therapeutic agents, and our understanding of its carcinogenesis and disease progression. Moreover, currently available risk stratification systems used to facilitate clinical decision-making have limitations, particularly in providing a personalized and patient-centered management strategy. Although prognosis and prostate cancer-specific survival have improved in recent years, the heterogenous behavior of the disease among patients included in the same risk prognostic group negatively impacts not only our clinical decision-making but also oncological outcomes, irrespective of the treatment strategy. Several biomarkers, along with available tests, have been developed to help clinicians in difficult decision-making scenarios and guide management strategies. In this review article, we focus on the scientific evidence that supports the clinical use of several biomarkers considered by professional urological societies (and included in uro-oncological guidelines) in the diagnosis process and specific difficult management strategies for clinically localized or advanced prostate cancer.