BIOMARKERS IN PROSTATE CANCER: CURRENT LIMITATIONS AND PERSPECTIVES FOR RADIOTHERAPY PERSONALIZATION
DOI:
https://doi.org/10.63330/sasciencesv6n2-211Keywords:
Biomarkers, Digital pathology, Genomics, Precision radiotherapy, Prostate cancerAbstract
Prostate cancer is one of the most common malignancies among men; despite high survival rates in localized cases, many patients experience recurrence and metastasis. Radiotherapy is a key therapeutic strategy, yet its application still relies on traditional clinical parameters that fail to fully capture tumor radiosensitivity or individual toxicity risk. In this context, biomarkers emerge as promising tools for personalizing management, thereby reducing both undertreatment and avoidable adverse effects. Therefore, this study aimed to analyze the current limitations and future prospects of biomarkers for personalized radiotherapy in prostate cancer. Specifically, the objectives were to: (a) classify their prognostic or predictive function; (b) synthesize recent clinical evidence; (c) identify analytical, methodological, and implementation barriers; and (d) propose criteria for responsible incorporation. This study is an integrative review with a critical scope, conducted via a structured search of publications from 2021 to 2026 in PubMed/MEDLINE. Results indicate that PSA and genomic classifiers refine prognosis but rarely demonstrate a treatment-biomarker interaction. PORTOS and digital pathology models showed the most consistent predictive signals in randomized trial analyses, whereas PSMA-PET alters treatment planning without yet serving as a universal marker of benefit. MicroRNA signatures for toxicity are promising but require independent validation and assessment of clinical utility. The study concludes that responsible implementation requires prospective validation, analytical standardization, demonstration of incremental benefit, algorithmic transparency, economic feasibility, and the integration of molecular, clinical, and dosimetric data.
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