A examine in JAMA Oncology reveals that MyProstateScore 2.0, a brand new urine take a look at 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 take a look at that measures 18 genes related to prostate most cancers gives increased accuracy for detecting clinically important cancers than PSA and different current biomarker checks, in response to a examine revealed on April 18 in JAMA Oncology. The urine take a look at, 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 stage, the brand new take a look at was able to ruling out the presence of clinically important prostate most cancers with exceptional accuracy. This enables sufferers to keep away from extra burdensome and invasive checks, like MRI and prostate biopsy, with nice confidence that we’re not lacking one thing,” mentioned Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Most cancers Analysis at Vanderbilt College Medical Heart, who’s first writer of the examine.
Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Most cancers Analysis at Vanderbilt College Medical Heart, who’s first writer of the examine.
Credit score: Vanderbilt College Medical Heart
Background on Prostate Most cancers Screening
Prostate most cancers is the commonest most cancers and the second main reason behind most cancers demise amongst males within the U.S. The PSA blood take a look at 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’s also elevated in a big proportion of males with out most cancers.
In consequence, the usage of elevated PSA alone to immediate a prostate biopsy ends in quite a few pointless biopsies. Though usually protected, prostate biopsies are invasive, uncomfortable, and carry some threat of worrisome problems. Due to this fact, for sufferers with an elevated PSA, there’s a nice want for a second-line take a look at to raised determine which males really want a biopsy and which don’t.
Improvement of MPS2
As a result of some low-grade, prostate cancers don’t require therapy and could be safely monitored with an method termed lively surveillance, the MPS2 take a look at was developed to detect extra particularly the higher-grade, “clinically important” cancers in want of early detection and therapy.
To do that, the analysis workforce analyzed prostate tumors from throughout the U.S. to determine novel genes extra usually detected within the presence of great cancers. Probably the most informative 18 genes have been mixed into the MPS2 take a look at, which was then examined in a Nationwide Most cancers Institute trial of males with an elevated PSA stage.
Uniquely, the authors have been in a position to evaluate the novel take a look at to different prostate most cancers checks, together with the unique, two-gene MPS take a look at.
Examine Outcomes and Comparability
The examine concerned 743 males with a median age of 62 years and a median PSA stage of 5.6. Whereas current biomarker checks might have prevented 15% to 30% of pointless biopsies (i.e. biopsies that have been damaging or discovered low-grade cancers not requiring therapy), use of MPS2 would have prevented 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 damaging biopsy, lowering the speed of pointless biopsies from 46% to 51% with use of MPS2, as in comparison with 9% to 21% for current checks.
Future Analysis and Limitations
Multiparametric magnetic resonance imaging (mpMRI) is one other second-line take a look at that has been utilized, however whereas it could possibly enhance detection of clinically important prostate most cancers, interpretation of the outcomes could be subjective and range considerably. The authors additionally famous that mpMRI isn’t out there in some group settings and isn’t an choice for some sufferers. The present examine was not designed to check biomarkers to mpMRI, however the researchers are at present conducting a potential, multicenter trial for that goal.
In sufferers proven to be with out clinically important prostate most cancers by the brand new take a look at, 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 contributors have been African American. As a result of prostate most cancers is extra prevalent amongst African American males, the analysis workforce is at present pursuing additional analyses in additional racially numerous populations.
For extra on this analysis, see New Urine-Primarily based Take a look at Detects Excessive-Grade Prostate Most cancers.
Reference: “Improvement and Validation of an 18-Gene Urine Take a look at 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 writer 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 Heart (U2C CA271854), and the EDRN DMCC (U24 CA086368).