MyProstateRating 2.0, a urine check for prostate most cancers, provides high accuracy and fewer pointless biopsies in comparison with conventional PSA assessments, in line with current analysis.
A research in JAMA Oncology reveals that MyProstateRating 2.0, a brand new urine check analyzing 18 genes, surpasses PSA in detecting vital prostate cancers and will scale back pointless biopsies by as much as 42%.
A brand new urine check that measures 18 genes related to prostate most cancers offers larger accuracy for detecting clinically vital cancers than PSA and different present biomarker assessments, in line with a research printed on April 18 in JAMA Oncology. The urine check, MyProstateRating 2.0 (MPS2), was proven to meaningfully scale back pointless prostate biopsies whereas offering extremely correct detection of worrisome prostate cancers, the researchers concluded.
“In nearly 800 patients with an elevated PSA level, the new test was capable of ruling out the presence of clinically significant prostate cancer with remarkable accuracy. This allows patients to avoid more burdensome and invasive tests, like MRI and prostate biopsy, with great confidence that we are not missing something,” mentioned Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Cancer Research at Vanderbilt University Medical Center, who’s first creator of the research.
Jeffrey Tosoian, MD, assistant professor of Urology and director of Translational Cancer Research at Vanderbilt University Medical Center, who’s first creator of the research. Credit: Vanderbilt University Medical Center
Background on Prostate Cancer Screening
Prostate most cancers is the most typical most cancers and the second main explanation for most cancers demise amongst males within the U.S. The PSA blood check has been extensively used because the preliminary step in prostate most cancers screening. Although PSA is elevated within the overwhelming majority of males with prostate most cancers, additionally it is elevated in a major proportion of males with out most cancers.
As a end result, using elevated PSA alone to immediate a prostate biopsy ends in quite a few pointless biopsies. Although usually secure, prostate biopsies are invasive, uncomfortable, and carry some threat of worrisome problems. Therefore, for sufferers with an elevated PSA, there’s a nice want for a second-line check to higher establish which males really want a biopsy and which don’t.
Development of MPS2
Because some low-grade, prostate cancers don’t require therapy and could be safely monitored with an strategy termed lively surveillance, the MPS2 check was developed to detect extra particularly the higher-grade, “clinically significant” cancers in want of early detection and therapy.
To do that, the analysis group analyzed prostate tumors from throughout the U.S. to establish novel genes extra usually detected within the presence of great cancers. The most informative 18 genes have been mixed into the MPS2 check, which was then examined in a National Cancer Institute trial of males with an elevated PSA stage.
Uniquely, the authors have been in a position to examine the novel check to different prostate most cancers assessments, together with the unique, two-gene MPS check.
Study Results and Comparison
The research concerned 743 males with a median age of 62 years and a median PSA stage of 5.6. While present biomarker assessments may have averted 15% to 30% of pointless biopsies (i.e. biopsies that have been destructive 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 vital most cancers.
The enchancment was much more pronounced in males with a historical past of a earlier destructive biopsy, lowering the speed of pointless biopsies from 46% to 51% with use of MPS2, as in comparison with 9% to 21% for present assessments.
Future Research and Limitations
Multiparametric magnetic resonance imaging (mpMRI) is one other second-line check that has been utilized, however whereas it could possibly enhance detection of clinically vital prostate most cancers, interpretation of the outcomes could be subjective and fluctuate considerably. The authors additionally famous that mpMRI will not be obtainable in some group settings and isn’t an possibility for some sufferers. The present research was not designed to check biomarkers to mpMRI, however the researchers are presently conducting a potential, multicenter trial for that objective.
In sufferers proven to be with out clinically vital prostate most cancers by the brand new check, the authors concluded that the “externally validated performance of MPS2 supports its effectiveness in accurately ruling out the need for mpMRI and biopsy altogether.” They famous a limitation of the research was that solely 13% of contributors have been African American. Because prostate most cancers is extra prevalent amongst African American males, the analysis group is presently pursuing additional analyses in additional racially numerous populations.
For extra on this analysis, see New Urine-Based Test Detects High-Grade Prostate Cancer.
Reference: “Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer” 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 Study 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 University of Michigan, the place Tosoian and Arul Chinnaiyan, MD, PhD, initiated the research. Chinnaiyan and John T. Wei, MD, are the research’s senior authors. Other Vanderbilt researchers who contributed to the research are Nathan Samora, MD, and Hunter Robinson, MD.
The research acquired funding help from the Prostate Cancer Foundation Young Investigator Award (Tosoian), Michigan-Vanderbilt EDRN Biomarker Characterization Center (U2C CA271854), and the EDRN DMCC (U24 CA086368).
