Background: Urine may represent a convenient source of biomarkers for the early detection of Prostate
Cancer (PCa) since it contains secreted prostatic products and exfoliated tumor cells. Furthermore, urine is easy to
collect with non-invasive procedures which are repeatable.
Method: Several urinary biomarkers for PCa have been proposed in the past but only one (PCA3) has been approved
for clinical use and even this is not widely utilized in the routine practice. Most of these, particularly the proteins,
were abandoned due to lack of confirmation. DNA markers have been proposed but they are less suitable compared
to other malignancies, such as bladder cancer due to the limited amount of DNA somatic alterations in PCa compared
to gene fusions and pathway activations.
Conclusion: RNA biomarkers are still the most promising and particularly miRNA and AMACR mRNA but the
main weaknesses that prevented the full clinical implementation are the absence of a validated of the cut-off levels
and the identification of consistent reference standards.