Integrated pathway to detect prostate cancer early obviate need for biopsy
A research article published in EUROPEAN UROLOGY ONCOLOGY validated a pathway that finds MRI biomarkers and microRNAs as triage tests for the early detection of prostate cancer. In this study, a team of researchers found that the pathway provides the best net benefit. The pathway bypasses unnecessary biopsy at the avoidance rate of 20% at a low disease probability. It may facilitate allocating patients accurately for biopsy and risk stratification.
One of the most commonly diagnosed cancers in men is Prostate cancer (PCa). There is an urgent need to integrate noninvasive imaging and circulating microRNAs beyond prostate-specific antigens for screening and detecting PCa early.
Considering this background, researchers in a prospective single-centre cohort study validated magnetic resonance imaging (MRI) biomarkers and circulating microRNAs as triage tests for patients directed to prostate biopsy. They tested different diagnostic pathways to compare their performance on patients’ outcomes regarding unnecessary biopsy avoidance. They included patients suspicious of PCa and underwent MRI, MRI-directed fusion biopsy (MRDB), and circulating microRNAs. They used a network-based analysis for identifying MRI biomarkers and microRNA drivers of clinically significant PCa.
The study Results are:
- Researchers enrolled 261 patients.
- These underwent MRDB for detecting prostate cancer.
- A total of 178 patients represented the entire cohort.
- Fifty-five patients constituting 30.9 %, were PCa negative, 39 constituting 21.9%, had grade group (GG) 1 PCa, and 84 constituting 47.2%, had GG >1 PCa.
- The proposed integrated pathway provided the best net benefit, including clinical data, MRI biomarkers, and microRNAs.
- The biopsy avoidance rate was 20% at a low disease probability.
They said, “The main limitation is the monocentric design in a referral centre.”
They said the integrated pathway represents a validated model that sees MRI biomarkers and microRNAs as a prebiopsy triage of patients at risk for clinically significant PCa.
The most significant benefit of the proposed pathway was unnecessary biopsy avoidance.
The pathway allows accurate patient allocation to biopsy and stratification into risk group categories. This will reduce overdiagnosis and overtreatment of clinically insignificant Prostate cancer.
Further reading:
https://euoncology.europeanurology.com/article/S2588-9311(23)00108-6/fulltext
