Usefulness of BRCA and ctDNA as Prostate Cancer Biomarkers: A Meta-Analysis

SIMPLE SUMMARY: Prostate cancer (PCa) represents the most common male urologic neoplasia. In the present study, the authors performed a review of scientific literature to establish the most potentially valuable biomarkers. After this a meta-analysis of two most interesting biomarkers (BRCA 1 and 2 and ctDNA) has been performed to evaluate their utility for the diagnostics, treatment, and prognosis of prostate cancer. The obtained results can help select the best diagnostic tool for early prostate diagnosis. To date, no ideal PCa biomarker has been found. Although BRCA1 and BRCA2 work well for breast and ovarian cancers, they do not seem to be reliable for prostate cancer. In our opinion, ctDNA seems to be a very promising biomarker, but still more research in this field is needed. ABSTRACT: Prostate cancer represents the most common male urologic neoplasia. Tissue biopsies are the gold standard in oncology for diagnosing prostate cancer. We conducted a study to find the most reliable and noninvasive diagnostic tool. We performed a systematic review and meta-analysis of two biomarkers which we believe are the most interesting: BRCA (BRCA1 and 2) and ctDNA. Our systematic research yielded 248 articles. Forty-five duplicates were first excluded and, upon further examination, a further 203 articles were excluded on the basis of the inclusion and exclusion criteria, leaving 25 articles. A statistical analysis of the obtained data has been performed. With a collective calculation, BRCA1 was expressed in 2.74% of all cases from 24,212 patients examined and BRCA2 in 1.96% of cases from 20,480 patients. In a total calculation using ctDNA, it was observed that 89% of cases from 1198 patients exhibited high expression of circulating tumor DNA. To date, no ideal PCa biomarker has been found. Although BRCA1 and BRCA2 work well for breast and ovarian cancers, they do not seem to be reliable for prostate cancer. ctDNA seems to be a much better biomarker; however, there are few studies in this area. Further studies need to be performed.