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Biomarker research is an area of great interest in prostate cancer (PCa) and holds potential to individualise treatment and improve outcomes. Owing to the heterogeneity of PCa and the imperfection of traditional diagnostic and risk stratification tools, there is an unmet need for novel biomarkers to provide better information on disease aggressiveness and to predict treatment outcomes. A deluge of biomarkers have been developed in recent years that offer utility at various time points in the management pathway for localised PCa. In order to appraise these biomarkers and examine their impact on treatment selection, a clear understanding of the different classes and function of biomarkers is necessary (Fig. 1).

The vast majority of current PCa biomarkers are diagnostic in nature, improving the detection of significant disease by guiding decisions on initial and repeat biopsies [1]. Prognostic and predictive markers have …