Genomic Classifiers
Genomic classifiers or gene expression biomarkers are additional tools that may aid in understanding prognosis. They are recommended to be used only when the test results could possibly alter the treatment plan. Prognosis, or how you will do with treatment, is most often based on your Gleason score/Grade Group information, PSA levels, tumor extent (T-stage) and number of biopsies that are positive for cancer.
2 Minute ReadWhat are genomic classifiers or gene expression biomarkers?
Unlike genetic testing, which looks at inherited traits, genomic testing focuses on changes in the genes of the cancer cells themselves.
Gene expression biomarkers are specific genes or patterns of gene activity that can be measured in a patient’s tissue. It involves taking a tissue sample from the prostate tumor, usually obtained during a biopsy or surgical specimen, and analyzing it in a lab to identify specific genetic changes. Typically, genomic testing does not require a new biopsy. Rather, the initial biopsy can be used for this type of testing.
Every cell in the body has the same DNA, but different genes are turned on or off (expressed or not expressed) in different cells and under different conditions. Measuring which genes are active in cancer cells can give clues about how aggressive the cancer is or how it might respond to treatment.
Purpose in Prostate Cancer
The goal of genomic testing in localized prostate cancer is to better understand the behavior of the cancer – how aggressive it is and how likely it is to grow and spread. In some cases, such as a low volume/low grade cancer, the prognosis is quite favorable and does not require additional genomic testing. In other cases, it may be helpful to learn additional information about the cancer, and gene expression biomarkers can reveal underlying genetic activity driving it.
Role in Risk Stratification and Influencing Treatment Decisions
Genomic testing is used together with traditional risk assessment methods. Combining genomic information with PSA levels, Gleason score, and other clinical data offers a more comprehensive understanding of the cancer.
Based on the results, treatment plans can be tailored more effectively. For example, those with a low-risk genomic profile might be a good candidate for active surveillance, while those with a higher risk profile may require treatment.
The Future of Personalized Medicine
The field is rapidly evolving, with ongoing research aimed at identifying new biomarkers and understanding how they can be best used in clinical practice.