Prostate cancer is highly heterogeneous, ranging from slow-growing tumors to aggressive, life-threatening disease. Current diagnostic methods, such as prostate-specific antigen (PSA) testing and digital rectal examination, have important limitations: PSA levels can rise due to benign conditions, while Gleason scoring of biopsies is subjective and prone to misclassification. These challenges lead to frequent overdiagnosis and overtreatment, as well as missed detection of aggressive tumors. Researchers have therefore turned to molecular biomarkers to fill the diagnostic gap. MicroRNAs, which are stable in tissues and body fluids, offer a promising noninvasive alternative. Due to these challenges, there is an urgent need to conduct deeper research on microRNA panels for prostate cancer diagnosis.
A review (DOI: 10.1002/uro2.105) published in UroPrecision (February 2025) by researchers from King George's Medical University, India, brings fresh insights into the diagnostic potential of microRNA panels for prostate cancer. The article synthesizes global studies demonstrating how combinations of microRNAs, identified in tissue and liquid biopsies, can act as reliable biomarkers. By providing higher specificity and sensitivity than conventional tests, these panels could support more accurate risk assessment, early detection, and personalized treatment strategies for men with prostate cancer.
The review summarizes extensive evidence showing that single microRNAs often lack the robustness to serve as independent biomarkers, but panels combining several microRNAs markedly improve diagnostic accuracy. In solid biopsies, panels such as miR-17-3p, miR-27a-3p, miR-200a-3p, miR-375, and miR-376b-3p have shown strong predictive power for metastasis (AUC up to 89.5%). Similarly, four-microRNA models including miR-23a-3p, miR-10b-5p, miR-133a-3p, and miR-374b-5p were validated as prognostic markers for biochemical recurrence.
Liquid biopsy research further strengthens their promise. Panels detected in serum, plasma, and urine—such as miR-146a-5p, miR-24-3p, and miR-93-5p—have achieved diagnostic accuracies above 80%. Others, like miR-141, miR-151-3p, and miR-16 combined with PSA levels, demonstrated near-perfect sensitivity and specificity (AUC 0.968). Urinary exosome-derived microRNA panels have even reached 100% sensitivity and specificity in distinguishing prostate cancer from benign prostatic hyperplasia and healthy controls.
The review also explores the interplay between microRNAs and circular RNAs, which act as “sponges” regulating tumor pathways. These networks may uncover new therapeutic targets, underscoring that microRNA panels are not just diagnostic tools but also keys to understanding disease progression.
“MicroRNA panels represent one of the most exciting frontiers in precision oncology,” notes Dr. Mohammad Kaleem Ahmad, senior author of the review. “Their stability in body fluids, coupled with their ability to capture the complexity of prostate cancer biology, makes them ideal candidates for noninvasive diagnostics. What is particularly encouraging is the consistency of results across diverse populations and sample types, from blood to urine. As validation expands, these biomarkers could become part of routine clinical practice, significantly reducing misdiagnosis and improving patient outcomes”.
The clinical application of microRNA panels could transform prostate cancer management by enabling earlier and more accurate detection while sparing patients from unnecessary invasive procedures. Incorporating these biomarkers into screening programs may help differentiate indolent from aggressive cancers, guiding treatment choices more precisely. Beyond diagnostics, integrating microRNA profiles with bioinformatics could illuminate novel therapeutic pathways, offering new drug targets. With their scalability in liquid biopsy tests, microRNA panels hold promise for broad population-level screening and personalized medicine, potentially reshaping global strategies for prostate cancer prevention, monitoring, and therapy in the coming decade.
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References
DOI
10.1002/uro2.105
Original Source URL
https://doi.org/10.1002/uro2.105
About UroPrecision
UroPrecision is an open access urology journal. We publish the latest, practical, timely, and cutting-edge content on investigations and treatment of urological diseases to physicians and researchers practicing precision urology worldwide. Coverage spans diverse medical disciplines, including oncology, endocrine gland diseases and metabolic diseases, artificial intelligence, medical imaging, biomedical engineering, robotic surgery, and clinical research.