Urinary biomarkers for prostate cancer

Urine may represent a convenient source of biomarkers for the early detection of prostate cancer (PCa) since contains secreted prostatic products and exfoliated tumor cells. Furthermore urine are easy to collect with non-invasive procedures and they are repeatable. Several urinary biomarkers for PCa have been proposed in the past but only one (PCA3) has been approved for clinical use and even this is not widely utilized in the routine practice. Most of these, particularly the proteins, were abandoned due to lack of confirmation. DNA markers have been proposed but they result less suitable compared to other malignancies such as bladder cancer due to the limited amount of DNA somatic alterations in PCa compared to gene fusions and pathway activations. RNA biomarkers are still the most promising and particularly miRNA and AMACR mRNA but the main weaknesses that prevented the full clinical implementation are the absence of a validated of the cut-off levels and the identification of consistent reference standards.