(HealthDay News) — A new prostate cancer test has higher diagnostic accuracy for high-grade disease than current guideline-endorsed biomarkers, according to a study published online April 18 in JAMA Oncology.
Jeffrey J. Tosoian, MD, MPH, from Vanderbilt University Medical Center in Nashville, TN, and colleagues developed a multiplex urinary panel for high-grade prostate cancer and validated its external performance relative to current guideline-endorsed biomarkers. The new urinary test for high-grade prostate cancer modeled gene expression and clinical factors (18-gene MyProstateScore 2.0 [MPS2]). Optimal models were developed in parallel with and without prostate volume (MPS2+ and MPS2). The development cohort included 761 men and the validation cohort included 743 men (20.3% with high-grade prostate cancer on biopsy).
The researchers found that the area under the receiver operating characteristic curve values were 0.60 using prostate-specific antigen alone, 0.66 using the risk calculator, 0.77 using the Prostate Health Index, 0.76 and 0.72 using the derived multiplex 2- and 3-gene models, respectively, and 0.74 using the original 2-gene MPS model compared with 0.81 and 0.82 for the MPS2 and MPS2+ models, respectively. The MPS2 model would reduce unnecessary biopsies performed in the initial biopsy population (range, 35 to 42% for MPS2 versus 15 to 30% for other tests) and repeat biopsy population (range, 46 to 51% for MPS2 versus 9 to 21% for other tests) at 95% sensitivity.
“These findings suggest that use of the test in patients with elevated prostate-specific antigen levels can reduce the potential harms of prostate cancer screening while preserving its long-term benefits,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry; several authors hold study-related patents.
