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Biomarkers & Genomic Testing

Biomarker testing in prostate cancer can tell you more about your specific diagnosis. This information may help you and your doctor decide which treatment is best for you.

Genetic testing for prostate cancer

Biomarker testing in prostate cancer

Biomarker testing in prostate cancer looks at how certain sets of genes in the tumor interact and function. It can be performed on both biopsy tissue and on tissue from an entire prostate following a prostatectomy (removal of the prostate by surgery). The activity of these genes can influence the behavior of the tumor, including how likely it is to grow and spread. Biomarker testing may also be called genomic, tumor, or somatic testing.

Biomarker testing may help you and your doctors decide on a treatment. These tests may be most helpful if you're newly diagnosed with prostate cancer that is still confined to the prostate. However, if you've had surgery and want to understand the risk of recurrence, you may also find this information helpful. By looking at the genetic makeup of prostate cancer, these tests may help predict whether your prostate cancer will grow slowly or aggressively.

This is different from genetic testing, which is a test to determine if you have a germline mutation. Genetic testing in prostate cancer is important because an inherited gene mutation may be responsible for up to 10% of all prostate cancers. A family history increases a man’s risk for prostate cancer by up to 60%.

View the table below for more information, and keep scrolling for more on biomarker testing.

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GENETIC OR GERMLINE TESTING

BIOMARKER OR SOMATIC TESTING

Inherited, or hereditary, mutationsAcquired mutations
Inherited – passed from parent to childNot passed from parent to child
Inherited gene mutations exist in every cell of the bodyAcquired gene mutations exist only in the tumor itself
10% of prostate cancer is thought to be caused by inherited, germline mutations90% of prostate cancer is thought to be due to non-inherited, acquired mutations
Provides eligibility for targeted cancer therapiesProvides eligibility for targeted cancer therapies
May provide information on family members' risk of developing certain cancersDoes not provide information on cancer risk in other family members
Identified through a blood or saliva sampleIdentified by testing the tumor itself or tumor cells that are circulating in the blood
 Video Preview: Why Consider Genetic or Somatic Testing
Video

Why consider biomarker or somatic testing?

In this video, Dr. Alicia Morgans explains how prostate cancer biomarker and somatic testing help in understanding a tumor's genetic makeup and inform which therapies can address its specific mutations. Click the image to watch it here, or the button below to visit YouTube.

Biomarker Testing Discussion Guide

This guide can support people with solid-tumor cancers, like prostate cancer, to ask their doctor or nurse the right questions about biomarker testing, including clinical trial options. Developed by the Lungevity Foundation. 

View or print the biomarker discussion guide

Biomarker testing and precision medicine

Biomarker testing and precision medicine are somewhat newer terms in the cancer space. More broadly, biomarker testing looks for genes, proteins, and tumor markers that tell us more about your specific cancer. Biomarkers can help doctors diagnose and monitor cancer and can also affect how some treatments will work for you.

In this broad sense, prostate-specific antigen (PSA) is also a biomarker, but new and emerging blood, urine, and tissue biomarkers are now available. The prostate health index, or PHI, as well as the 4KScore, are tests that help in diagnosing prostate cancer and identifying more aggressive disease, which may also reduce the number of prostate biopsies performed in patients with low PSA levels.

Biomarker testing - also called comprehensive genomic profiling (CGP), tumor testing, molecular profiling, tumor subtyping, or somatic testing - uses a single test to examine a person’s genes. The test looks for gene mutations that are relevant in cancer and may drive cancer growth. Some of these biomarkers tell your doctors how aggressive your prostate cancer might be. Biomarker testing may help you and your doctor better understand your cancer and choose the best treatment option.

Prostate cancer biomarker tests

Many prostate cancer biomarker tests are available. Some are used after a biopsy, some are used after a prostatectomy, and some are used if you have localized or advanced prostate cancer. These tests include ArteraAI Prostate Test®, Decipher®, FoundationOneLiquid CDX®, Genomic Prostate Score® (GPS) Test, ProstaVysion®, Prolaris®, etc. Learn more about these biomarker tests and others under Additional Tests for Prostate Cancer.

Talk to your doctor about when your tumor should be tested and which biomarker test is right for you.

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4Kscore

A blood test providing patient-specific probability of finding an aggressive form of prostate cancer during a biopsy. The test measures total PSA, free PSA, intact PSA and kallikrein enzymes. The company then uses this information and the patient's age and physical exam to calculate the probability percentage of having aggressive disease.

Genetic

The branch of biology concerned with the study of genes, genetic variation, and heredity in organisms; relating to genes or heredity.

Germline

Is the population of cells that pass on their genetic material. Germline genetic tests look for inherited, or hereditary, genetic mutations.

Genomic

The study of all of a person's genes (the genome); field of biology focusing on the structure, function, evolution, mapping, and editing of genomes.

Gene

The gene is the basic physical unit of inheritance. A unit of heredity which is transferred from a parent to offspring and is held to determine some characteristic of the offspring.

Germline Mutation

A germline mutation occurs in a sperm cell or an egg cell and is passed directly from a parent to a child at the time of conception. Because the mutation affects reproductive cells, it can pass from generation to generation. Cancer caused by germline mutations is called inherited or hereditary cancer.

Genetic Testing

The testing of genes and heredity and how certain traits and qualities are passed to offspring from parents as a result of changes in DNA sequence. The results of a genetic test can confirm or rule out a suspected genetic condition, help determine a person's chance of developing or passing on a genetic disorder, and provide information on how the cancer might behave. Genetic testing is useful in many areas of medicine and can change the medical care you or your family member receives.

Biomarkers

A measurable indicator of the severity or presence of some disease state. More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an organism.

Biopsy

For a biopsy, the doctor takes out a small piece of tissue where the cancer seems to be. This tissue is checked for cancer cells. A core needle biopsy is often used to find prostate cancer.

Precision Medicine

Medical care designed to optimize efficiency or therapeutic benefit for particular groups of patients, especially by using genetic or molecular profiling.

Prostate-Specific Antigen (PSA)

Prostate-specific Antigen (PSA) is a substance found in the blood that is made by the prostate gland. A PSA test measures the level of PSA and is the leading method of screening for prostate cancer.

Somatic

Referring to the cells of the body in contrast to the germ line cells.

Recurrence

The return of cancer after treatment. Local recurrence means that the cancer has come back at the same place as the original cancer (primary site). Regional recurrence means that the cancer has come back after treatment in the lymph nodes near the primary site. Distant recurrence is when cancer spreads (metastasizes) after treatment to distant organs or tissues (such as the lungs, liver, bone marrow, or brain).

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