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Urine test predicted results of prostate biopsy
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2010 Genitourinary Cancers Symposium
The PCA3 urine test accurately predicted whether a prostate biopsy would detect cancer in a prospective subanalysis of patients in the Reduction by Dutasteride of Prostate Cancer Events — or REDUCE — trial.
Jack Groskopf, PhD, director of research and development in cancer diagnostics at Gen-Probe, presented the findings of the analysis during a press conference in advance of the 2010 Genitourinary Cancers Symposium. He said these latest results expand on previous studies indicating that the PCA3 test is another tool to determine how frequently prostate cancer biopsies are necessary.
The PCA3 gene is over-expressed in prostate cancers but not in benign prostate disorders such as prostatitis or enlarged prostate. The PCA3 molecular test measures PCA3 expression in urine samples. The test is being test marketed in Europe and is available in some certified laboratories in the United States as a laboratory developed test.
“The PCA3 scores correlated with risk of a positive biopsy,” Groskopf said. “We also found that PCA3 could add value on top of a multivariate model using serum PSA and other clinical information. PCA3 had greater specificity than serum PSA.”
When comparing PCA3 scores at two years vs. biopsy outcomes at four years, it is possible that PCA3 picked up cancers undetected by biopsy, according to Groskopf.
Researchers evaluated the test in 1,072 men in the placebo arm of REDUCE. They found that only 6% of men with a PCA3 score less than 5 were later diagnosed with cancer. In contrast, 57% of those with a score of 100 or greater were later found to have cancer.
Groskopf said median PCA3 scores were higher in men with high-grade cancers than in those with low-grade cancers. In addition, men with elevated PCA3 scores and a negative biopsy at two years from baseline were twice as likely to have cancer detected through prostate biopsy at four years compared with men with lower PCA3 scores.
For more information:
- Groskopf J. #3. Presented at: 2010 Genitourinary Cancers Symposium; March 5-7, 2010; San Francisco.
The ability of this test to predict biopsy positivity, particularly in patients whose PSA is elevated above 2.5, is potentially very helpful and may also help us identify more aggressive cancers. We still do not have a good way to identify more aggressive cancers, except through repeat biopsy.
- Nicholas J. Vogelzang, MD
HemOnc Today Editorial Board member
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