A novel serum biomarker quintet reveals added prognostic value when combined with standard clinical parameters in prostate cancer patients by predicting biochemical recurrence and adverse pathology

PLoS One. 2021 Nov 12;16(11):e0259093. doi: 10.1371/journal.pone.0259093. eCollection 2021.

Abstract

The objective was to determine the prognostic utility of a new biomarker combination in prostate cancer (PCa) patients undergoing Radical Prostatectomy (RP). Serum samples and clinical data of 557 men who underwent RP for PCa with pathological stage (pT) <3 at Martini Clinic (Hamburg, Germany) were used for analysis. Clinical Grade Group and clinical stage was determined using biopsy samples while tumor marker concentrations were measured in serum using immunoassays. The prognostic utility of the proposed marker combination was assessed using Cox proportional hazard regression and Kaplan-Meier analysis. The performance was compared to the Cancer of the Prostate Risk Assessment (CAPRA) score in the overall cohort and in a low-risk patient subset. A multivariable model comprising fibronectin 1, galectin-3-binding protein, lumican, matrix metalloprotease 9, thrombospondin-1 and PSA together with clinical Grade Group (GG) and clinical stage (cT) was created. The proposed model was a significant predictor of biochemical recurrence (BCR) (HR 1.29 per 5 units score, 95%CI 1.20-1.38, p<0.001). The Kaplan-Meier analysis showed that the proposed model had a better prediction for low-risk disease after RP compared to CAPRA (respectively 5.0% vs. 9.1% chance of BCR). In a pre-defined low risk population subset, the risk of BCR using the proposed model was below 5.2% and thus lower when compared to CAPRA = 0-2 (9%), GG<2 (7%) and NCCN = low-risk (6%) subsets. Additionally, the proposed model could significantly (p<0.001) discriminate patients with adverse pathology (AP) events at RP from those without. In conclusion, the proposed model is superior to CAPRA for the prediction of BCR after RP in the overall cohort as well as a in a pre-defined low risk patient population subset. It is also significantly associated with AP at RP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Neoplasm / blood
  • Biomarkers, Tumor / blood
  • Germany / epidemiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Prognosis
  • Prostate-Specific Antigen / blood*
  • Prostatectomy / methods*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • LGALS3BP protein, human
  • Prostate-Specific Antigen

Grants and funding

Proteomedix AG provided support for this study in the form of salaries for AA, AW, RH, OS, and RS. The specific roles of these authors are articulated in the ‘author contributions’ section. Proteomedix funded and participated in the study design, sample and data analysis, preparation, and publication of the manuscript.