Study finds new urine-based test to detect prostrate cancer

The study was published in the journal JAMA Oncology.

Prostate cancer is a prevalent and deadly malignancy globally. Screening trials like the European Randomized Study of Screening for Prostate cancer and Göteborg Randomized Prostate Cancer Screening trial have demonstrated reduced cancer mortality with PSA-based screening. Current guidelines suggest men with high PSA levels undergo risk stratification via multiparametric magnetic resonance imaging or biomarker testing before biopsy.

The test, called MyProstateScore2.0, or MPS2, looks at 18 different genes linked to high-grade prostate cancer. In multiple tests using urine and tissue samples from men with prostate cancer, it successfully identified cancers classified as Grade Group 2, or higher. These cancers are more likely to grow and spread compared to Grade Group 1 prostate cancers, which are unlikely to spread or cause other impact.

In the study, multiple biomarker tests were assessed, including serum PSA alone, the Prostate Cancer Prevention Trial risk calculator, and the Prostate Health Index (PHI) and the 18-gene MPS2 models. Under a testing approach with 95% sensitivity for Prostate cancer of Grade group 2 or greater, measures of diagnostic accuracy and clinical consequences of testing were calculated. Cancers of GG 3 or greater were assessed secondarily.

Of 761 men included in the study, 151 had high-grade Prostate cancer on biopsy. Area under the graph showed 0.74 using the original MPS model compared with 0.81 using the MPS2 model and 0.82 using the MPS2+ model. Across pertinent subgroups, the MPS2 models had negative predictive values of 95% to 99% for cancers of Grade group 2 or greater and of 99% for cancers of Grade group 3 or greater.

The findings suggested that the use of this test would meaningfully reduce unnecessary biopsies performed while maintaining highly sensitive detection of high-grade cancers. The data supported use of this new Prostate cancer biomarker test in patients with elevated PSA levels to reduce the potential harms of prostate cancer screening while preserving its long-term benefits.

Reference: Jeffrey J. Tosoian, MD, MPH; Yuping Zhang, PhD; Lanbo Xiao, PhD; et al; Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer; Journal: JAMA Oncology; doi:10.1001/jamaoncol.2024.0455