Biomarkers & Genomic Testing

Genomic testing and 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

Genomics in prostate cancer

Genomics is the study of all the genes in the genome and their interactions with the environment. This is related to but not the same as genetics, the study of individual genes and inherited traits from one generation to the next.

A table summarizing the differences between germline and somatic testing for prostate cancer

The study of genetics 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 60%.

Genomics in prostate cancer looks at how certain sets of genes in the prostate cancer tumor interact and function. The activity of these genes can then influence the behavior of the tumor, including how rapidly it is likely to grow and spread.

Genomic testing in prostate cancer

Genomic testing is done on cancerous tissue taken from the prostate in order to provide information about how your prostate cancer might behave. It can be performed on both biopsy tissue and on tissue from an entire prostate following a prostatectomy (removal of the prostate by surgery).

Genomic testing is useful for helping prostate cancer patients and their doctors decide on a treatment. These tests are most helpful for those who are newly diagnosed with prostate cancer that is still confined to the prostate. However, men who have had surgery and want to understand their risk of recurrence may also find this information helpful. By looking at the genetic makeup of the prostate cancer, genomic tests may help predict whether a person's prostate cancer will grow slowly or aggressively.

Biomarker testing and precision medicine

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

Prostate-specific antigen (PSA) is the most widely used prostate cancer biomarker, but new and emerging blood, urine, and tissue biomarkers are also now available. The prostate health index, or PHI, as well as the 4KScore, are biomarker tests that help in diagnosing prostate cancer and identifying more aggressive disease, which also may reduce the number of prostate biopsies performed in men 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 mutations in genes that are relevant in cancer and that 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 particular cancer and choose the best treatment option for you.

Remember, biomarker testing is not the same as genetic testing. Genetic testing tells you which genes have been inherited -passed on to you by your parents.

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 Decipher®, FoundationOneLiquid CDX®, Genomic Prostate Score® (GPS) Test, ProstaVysion®, Prolaris®, PORTOS®, OncoTypeDX®, ArteraAI Prostate Test®, and others.

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