A examine in JAMA Oncology reveals that MyProstateScore 2.0, a brand new urine check analyzing 18 genes, surpasses PSA in detecting important prostate cancers and will cut back pointless biopsies by as much as 42%.
A brand new urine check that measures 18 genes related to prostate most cancers supplies increased accuracy for detecting clinically important cancers than PSA and different current biomarker assessments, based on a examine revealed on April 18 in JAMA Oncology. The urine check, MyProstateScore 2.0 (MPS2), was proven to meaningfully cut back pointless prostate biopsies whereas offering extremely correct detection of worrisome prostate cancers, the researchers concluded.
“In practically 800 sufferers with an elevated PSA degree, the brand new check was able to ruling out the presence of clinically important prostate most cancers with outstanding accuracy. This enables sufferers to keep away from extra burdensome and invasive assessments, like MRI and prostate biopsy, with nice confidence that we aren’t lacking one thing,” stated Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Most cancers Analysis at Vanderbilt College Medical Middle, who’s first creator of the examine.
Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Most cancers Analysis at Vanderbilt College Medical Middle, who’s first creator of the examine.
Credit score: Vanderbilt College Medical Middle
Background on Prostate Most cancers Screening
Prostate most cancers is the commonest most cancers and the second main explanation for most cancers demise amongst males within the U.S. The PSA blood check has been broadly used because the preliminary step in prostate most cancers screening. Though PSA is elevated within the overwhelming majority of males with prostate most cancers, it is usually elevated in a major proportion of males with out most cancers.
Consequently, using elevated PSA alone to immediate a prostate biopsy ends in quite a few pointless biopsies. Though usually secure, prostate biopsies are invasive, uncomfortable, and carry some threat of worrisome issues. Due to this fact, for sufferers with an elevated PSA, there’s a nice want for a second-line check to raised establish which males actually want a biopsy and which don’t.
Improvement of MPS2
As a result of some low-grade, prostate cancers don’t require therapy and will be safely monitored with an strategy termed energetic surveillance, the MPS2 check was developed to detect extra particularly the higher-grade, “clinically important” cancers in want of early detection and therapy.
To do that, the analysis crew analyzed prostate tumors from throughout the U.S. to establish novel genes extra usually detected within the presence of great cancers. Essentially the most informative 18 genes had been mixed into the MPS2 check, which was then examined in a Nationwide Most cancers Institute trial of males with an elevated PSA degree.
Uniquely, the authors had been in a position to evaluate the novel check to different prostate most cancers assessments, together with the unique, two-gene MPS check.
Examine Outcomes and Comparability
The examine concerned 743 males with a median age of 62 years and a median PSA degree of 5.6. Whereas current biomarker assessments might have averted 15% to 30% of pointless biopsies (i.e. biopsies that had been unfavorable or discovered low-grade cancers not requiring therapy), use of MPS2 would have averted 35% to 42% of pointless biopsies with out lacking any further diagnoses of clinically important most cancers.
The advance was much more pronounced in males with a historical past of a earlier unfavorable biopsy, decreasing the speed of pointless biopsies from 46% to 51% with use of MPS2, as in comparison with 9% to 21% for current assessments.
Future Analysis and Limitations
Multiparametric magnetic resonance imaging (mpMRI) is one other second-line check that has been utilized, however whereas it will probably enhance detection of clinically important prostate most cancers, interpretation of the outcomes will be subjective and differ considerably. The authors additionally famous that mpMRI shouldn’t be out there in some group settings and isn’t an choice for some sufferers. The present examine was not designed to match biomarkers to mpMRI, however the researchers are at the moment conducting a potential, multicenter trial for that objective.
In sufferers proven to be with out clinically important prostate most cancers by the brand new check, the authors concluded that the “externally validated efficiency of MPS2 helps its effectiveness in precisely ruling out the necessity for mpMRI and biopsy altogether.” They famous a limitation of the examine was that solely 13% of individuals had been African American. As a result of prostate most cancers is extra prevalent amongst African American males, the analysis crew is at the moment pursuing additional analyses in additional racially various populations.
For extra on this analysis, see New Urine-Based mostly Check Detects Excessive-Grade Prostate Most cancers.
Reference: “Improvement and Validation of an 18-Gene Urine Check for Excessive-Grade Prostate Most cancers” by Jeffrey J. Tosoian, Yuping Zhang, Lanbo Xiao, Cassie Xie, Nathan L. Samora, Yashar S. Niknafs, Zoey Chopra, Javed Siddiqui, Heng Zheng, Grace Herron, Neil Vaishampayan, Hunter S. Robinson, Kumaran Arivoli, Bruce J. Trock, Ashley E. Ross, Todd M. Morgan, Ganesh S. Palapattu, Simpa S. Salami, Lakshmi P. Kunju, Scott A. Tomlins, Lori J. Sokoll, Daniel W. Chan, Sudhir Srivastava, Ziding Feng, Martin G. Sanda, Yingye Zheng, John T. Wei, Arul M. Chinnaiyan, EDRN-PCA3 Examine Group, Ian M. Thompson, Mohamed Bidair, Adam Kibel, Daniel W. Lin, Yair Lotan, Alan Partin, Samir Taneja, David H. Howard, Meredith M. Regan, Jack Groskopf, Jonathan Chipman, Dattatraya H. Patil, Douglas S. Scherr, Jacob Kagan, Jing Fan, Aron Y. Joon, Leonidas E. Bantis and Mark A. Rubin, 18 April 2024, JAMA Oncology.
DOI: 10.1001/jamaoncol.2024.0455
Tosoian is co-first creator with Yuping Zhang, PhD, and Lanbo Xiao, PhD, professors on the College of Michigan, the place Tosoian and Arul Chinnaiyan, MD, PhD, initiated the examine. Chinnaiyan and John T. Wei, MD, are the examine’s senior authors. Different Vanderbilt researchers who contributed to the examine are Nathan Samora, MD, and Hunter Robinson, MD.
The examine acquired funding help from the Prostate Most cancers Basis Younger Investigator Award (Tosoian), Michigan-Vanderbilt EDRN Biomarker Characterization Middle (U2C CA271854), and the EDRN DMCC (U24 CA086368).