Suspicious prostate cancer screening results often follow a procedure most men would favor to avoid: a prostate biopsy. But what if biopsies might be avoided based on non-invasive test results? Screening tests are moving on this direction, with some interesting results. considered one of them, Prostate Health Index blood test, combines measures of three types of prostate-specific antigen (PSA) right into a rating that helps doctors predict whether cancer is prone to progress, with the goal of stopping biopsies that aren't vital. Another non-invasive test, called the PCA3 assay, measures genetic evidence of aggressive cancer in urine samples, and produces a rating designed to assist doctors predict the necessity for repeat biopsies. Although approved by the Food and Drug Administration, these tests aren't perfect, and experts query the reliability of the PCA3 test particularly.
Now researchers are considering the worth of a brand new test that also looks for evidence of advanced prostate cancer in urine. gave Results were reported I Journal of the American Medical Association Last April. Called the “Urine Extrinsic Gene Expression Assay,” it measures not only PCA3 but two other genes related to advanced disease: ERG and SPDEF. The test combines these measures right into a diagnostic rating that “can help determine whether an early prostate biopsy is needed,” said co-developer Dr. Michael Donovan, of The Mount Sinai Hospital in New York. He is an epidemiologist and researcher. According to Donovan, the goal is to limit the variety of prostate cancer biopsies, that are expensive, painful and liable to hospital-acquired infections.
The study enrolled 1,563 men from 22 community and academic urology clinics within the United States. According to the outcomes of the ultimate grouping of 519 men, an assay rating above the “cut-off” value of 15.6 appropriately predicted advanced cancer 92 percent of the time. The assay was not at all times accurate: 12 men were misdiagnosed as having low-risk cancer after they actually had advanced disease. might be considered eligible for Active monitoring as a substitute of treatment.
The measured genes reside in small vesicles called exosomes which might be secreted by prostate cells. For the test, men must provide a “first catch” urine sample. This is because prostate secretions are concentrated within the initial stream and reduce in number as urination continues. “In our view, the assay can be combined with other standard-of-care factors during clinical decision-making,” Donovan said. “Right now, it's designed for men who have never had a biopsy, but we're also moving toward studies that will evaluate its use in other settings, such as active surveillance.”
