Prostate Specific Antigen (PSA): The Historical Perspective

In 1970, shortly after joining Roswell Park Memorial Institute, the New York State institute for the study of malignant diseases, the author initiated investigations on the use of tumor cell products for diagnosis and therapy of cancer. Immunochemical approaches were used primarily to differentiate quantitatively or qualitatively normal cells from tumor cells. Prostate cancer was a major area of endeavor, with the goal to identify and characterize prostate tumor specific and associated antigens, and eventually to develop a simple but reliable blood test for prostate cancer. Prostate cancer research had not received much attention at the time this work was begun. The early studies focused upon, among others, prostatic acid phosphatase, alkaline phosphatase, and new prostate tumor markers. By the mid 1970s, three able investigators--Dr. Ching-Li Lee, Dr. Carl S. Killian, and Dr. Ming C. Wang--had joined the prostate cancer research team, and were invited to take charge of these three research projects, respectively.

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An assessment of Prostate Cancer Research International: Active Surveillance (PRIAS) criteria for active surveillance of clinically low-risk prostate cancer patients

Canadian Urological Association Journal ◽

10.5489/cuaj.4093 ◽

2017 ◽

Vol 11 (8) ◽

pp. 238-43 ◽

Cited By ~ 1

Author(s):

Vitor Da Silva ◽

Ilias Cagiannos ◽

Luke T. Lavallée ◽

Ranjeeta Mallick ◽

Kelsey Witiuk ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Research ◽

Cancer Patients ◽

Active Surveillance ◽

Specific Antigen ◽

Low Risk ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer ◽

Psa Recurrence ◽

Prostate Cancer Research

Introduction: Active surveillance is a strategy to delay or prevent treatment of indolent prostate cancer. The Prostate Cancer Research International: Active Surveillance (PRIAS) criteria were developed to select patients for prostate cancer active surveillance. The objective of this study was to compare pathological findings from PRIAS-eligible and PRIAS-ineligible clinically low-risk prostate cancer patients.Methods: A D’Amico low-risk cohort of 1512 radical prostatectomy patients treated at The Ottawa Hospital or Memorial Sloan Kettering Cancer Centre between January 1995 and December 2007 was reviewed. Pathological outcomes (pT3 tumours, Gleason sum ≥7, lymph node metastases, or a composite) and clinical outcomes (prostate-specific antigen [PSA] recurrence, secondary cancer treatments, and death) were compared between PRIAS-eligible and PRIAS-ineligible cohorts.Results: The PRIAS-eligible cohort (n=945) was less likely to have Gleason score ≥7 (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.49‒0.75), pT3 (OR 0.41; 95% CI 0.31‒0.55), nodal metastases (OR 0.37; 95% CI 0.10‒1.31), or any adverse feature (OR 0.56; 95% CI 0.45‒0.69) compared to the PRIAS-ineligible cohort. The probability of any adverse pathology in the PRIAS-eligible cohort was 41% vs. 56% in the PRIAS-ineligible cohort. At median followup of 3.7 years, 72 (4.8%) patients had a PSA recurrence, 24 (1.6%) received pelvic radiation, and 13 (0.9%) received androgen deprivation. No difference was detected for recurrence-free and overall survival between groups (recurrence hazard ratio [HR] 0.71; 95% CI 0.46–1.09 and survival HR 0.72; 95% CI 0.36–1.47).Conclusions: Low-risk prostate cancer patients who met PRIAS eligibility criteria are less likely to have higher-risk cancer compared to those who did not meet at least one of these criteria.

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The impact of complications after diagnostic biopsy on repeat biopsy in men: Results from the Prostate Cancer Research International: Active surveillance (PRIAS-JAPAN) study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e17616 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e17616-e17616

Author(s):

Yoichiro Tohi ◽

Takuma Kato ◽

Ryuji Matsumoto ◽

Nobuo Shinohara ◽

Akira Yokomizo ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Research ◽

Active Surveillance ◽

Specific Antigen ◽

Repeat Biopsy ◽

Protocol Biopsy ◽

Cancer Aggressiveness ◽

Diagnostic Biopsy ◽

Prostate Cancer Research ◽

The Impact

e17616 Background: Active surveillance(AS) is the strategy to avoid the overtreatment for favorable prostate cancer. For safer AS protocol execution, repeat protocol biopsy is essential in evaluating cancer aggressiveness accurately. However, some men on AS refuse repeat protocol biopsy because of burdens on biopsy. We aimed to assess the complications of prostate biopsy and the impact of complications after diagnostic biopsy on repeat protocol biopsy from the analysis Japanese cohort forming part of the Prostate cancer Research International: Active surveillance (PRIAS) study. Methods: PRIAS-JAPAN started in January 2010, 39 institutions are participating in this study. Men are prospectively followed and repeat protocol biopsy are planned at 1 year and 4 years thereafter, or if prostate specific antigen-doubling time is < 10 years. Data was collected on the complications such as infection, hematuria, hematospermia, pain, and antibiotics, and approach of biopsy, retrospectively. We compared the complications in diagnostic biopsy between repeat biopsy acceptance group and repeat biopsy non-acceptance group at 1 year. Results: From 2010 to 2018, 862 men with low-risk prostate cancer were prospectively enrolled in PRIAS-JAPAN. 794 men (92%) actually proceeded to protocol at 1 year. Of the 794 men, repeat protocol biopsy non-acceptance rate at 1 year was 18.4%(146 men). According to differences in the complications of diagnostic biopsy, hematuria(p = 0.003) and pain(p < 0.001) rate were significantly higher in repeat biopsy non-acceptance group, but infection(p = 0.105) and hematospermia(p = 0.224). Approach of biopsy(p = 0.651) was not different in two groups. Conclusions: Hematuria and pain in diagnostic biopsy were significantly more frequent in repeat biopsy non-acceptance group. Our study supports the importance of adequate explanation and management of the complications at biopsy to improve the rate of protocol biopsy acceptance. [Table: see text]

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