Start at the End: A Strategy for Developing and Delivering Advanced Diagnostic Tests to improve Prostate Cancer Patient Outcomes

Although about one in every seven men in the developed world will be diagnosed with prostate cancer in their lifetime, the mortality rate remains low with a 99% five-year survival rate for low to intermediate grade disease. Following diagnosis, surgery (radical prostatectomy), radiation therapy, hormonal therapy and chemotherapy either singly or in combinations are options for initial treatment. However, active surveillance - where disease progression is carefully monitored - may be a more appropriate option for less advanced and low grade disease.

At present a diagnosis of prostate cancer is initially and most commonly made on the basis of three investigations: the prostate specific antigen (PSA) test, digital rectal examination (DRE) and biopsy-based grading of the tumour by histopathology. It is accepted that these tests do not provide adequate information to support the decision of whether to pursue immediate treatment or active surveillance. Hence, there is a significant unmet need for specific and sensitive biomarkers to guide the decision between treatment and active surveillance, as well as for regular monitoring of disease progression in men on active surveillance.  

Despite a few decades of proteomics research and the apparent discovery of multiple protein biomarkers to support the diagnosis and treatment decisions, the number of protein biomarkers that have been developed to the stage of being used routinely is disappointingly low.  So, it's clear that whilst there’s a huge need to develop new protein biomarkers as yet biomarker development and delivery is proving very challenging.  Why is this?

This presentation will demonstrate how SRM/MRM on triple quadrupole mass spectrometers affords huge potential as a platform for the development of specific and sensitive 'biomarker signatures' comprising multiple proteins.   Strategies for the delivery and implementation of multiplexed protein biomarkers to support improved clinical decision making following prostate cancer diagnosis will be described.

Learning Objectives:

1. Appreciate the challenges faced in the management of prostate cancer
2. Recognise the need for authentic protein biomaker discovery and strategies to acheive it
3. Undertand how MRM can be used for the development of analytically validated protein biomarker signatures.
4. Appreciate the challenges associated with the delivery of biomarker signatures for routine use and improved prostate cancer patient outcomes.

For Research Use Only. Not for use in diagnostic procedures.