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Researchers have found that a new urine test is extremely accurate at detecting aggressive prostate cancer with few false negatives.
The test could have avoided a third of unnecessary prostate cancer biopsies while detecting only a small number of cancers, according to a validation study of more than 1,500 patients.
The MyProstateScore test measures the levels of cancer-specific genes in a patient’s urine. It is based on previous research which found that half of all prostate tumors harbor some genetic defect in which the TMPRSS2 and ERG genes relocate on a chromosome and fuse together, creating a switch for cancer development. prostate.
One of the best current methods of detecting prostate cancer is a blood test for prostate specific antigen, commonly known as a PSA test. High levels of PSA can indicate cancer, but the majority of men with high PSA do not actually have prostate cancer.
To determine which patients have cancer or not, men with an elevated PSA test undergo an invasive procedure called a transrectal biopsy. Prostate biopsies are uncomfortable for patients and carry a low risk of complications. MRIs are also used to detect prostate cancer, but they can also miss out on cancerous lesions and lead to much higher costs and limited availability.
“Our ultimate goal was to determine if the MyProstateScore test could be a convenient and reliable test that could rule out the need for more expensive or invasive tests in men referred for a prostate biopsy,” says the study’s lead author. Jeffrey Tosoian, clinical professor of urology at Michigan Medicine.
Not all prostate cancers are this worrying. Many arise later in life and grow so slowly that the best course of action is to simply watch them. These are the patients with these slow-growing or cancer-free cancers who, despite having high PSA levels, could be spared the more invasive or expensive procedures with a better test, the researchers said.
The validation study included patients seen in academic health centers and community health facilities. Of these 1,525 patients, 338 – 2% – had cancers detected by grade 2 or greater biopsy from the group, meaning they were serious enough to warrant immediate treatment.
If the MyProstateScore test were available to study patients, 387 biopsies that found no cancer or slow-growing cancer could have been avoided, according to the study. During this time, the test would have missed only 10 clinically significant cancers that would have warranted immediate treatment.
“The data shows that this simple secondary testing approach could reduce the use of more expensive and invasive procedures after a PSA test,” says Tosoian.
Additional co-authors of the study, published in the Urology Journal, come from Johns Hopkins University, the Fred Hutchinson Cancer Research Institute and the University of Michigan.
The Prostate Cancer Foundation, the National Institutes of Health, the A. Alfred Taubman Medical Research Institute, and the University of Michigan funded the work.
LynxDX, a University of Michigan start-up that Tosoian and his colleagues founded and in which they have a stake, is marketing the test.
Source: University of Michigan
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