In a cohort of men with localized prostate cancer, preoperative steroid metabolome was associated with the risk of recurrence of high-risk disease. The prospective PROCURE cohort study included 1,766 patients with localized prostate cancer who provided blood samples prior to radical prostatectomy (RP). The levels of 15 steroids were measured in plasma and their association with prognostic factors and disease-free survival (DFS) was established using logistic regression and multivariable Cox proportional hazard models. Researchers found:
- Median follow-up time after surgery was 73.2 months.
- 524 patients experienced biochemical failure and 75 developed metastatic disease.
- Associations were observed between adrenal precursors and risk of cancer progression.
- In high-risk patients, a 1-unit increment in log-transformed androstenediol and dehydroepiandrosterone-sulfate levels were linked to DFS (HR 1.47).
Lévesque E, Caron P, Lacombe L, et al. A comprehensive analysis of steroid hormones and progression of localized high-risk prostate cancer. [Published online ahead of print March 27, 2019]. Cancer Epidemiol Biomarkers Prev. doi:10.1158/1055-9965.EPI-18-1002.
More accurate prognostic and predictive biomarkers are needed for prostate cancer. Current biomarkers for prostate cancer, including PSA and Gleason score, are imperfect. The authors explore whether select steroid hormones related to testosterone metabolism may predict prostate cancer outcomes. They employed a very sensitive technique, mass spectrometry. The study was exploratory in nature, and 2 hormones were found to be associated with disease-free survival. The findings are not mature nor compelling enough to reach clinical practice at this time but do support further work in studying the metabolome alongside other biomarkers as part of a larger scope of “panomics.” —Mark A. Klein, MD