2112 CORRELATION OF URINE PCA3 SCORE AND TMPRS2:ERG SCORE WITH CLINICALLY SIGNIFICANT TUMOR VOLUME IN RADICAL PROSTATECTOMY SPECIMENS: INTERIM RESULTS FROM A MULTI-CENTER PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 20122112 CORRELATION OF URINE PCA3 SCORE AND TMPRS2:ERG SCORE WITH CLINICALLY SIGNIFICANT TUMOR VOLUME IN RADICAL PROSTATECTOMY SPECIMENS: INTERIM RESULTS FROM A MULTI-CENTER PROSPECTIVE STUDY John Davis, Patricia Troncoso, Sarah Meyer, John Day, Jack Groskopf, Sheila Aubin, Yvonne Rodriguez, Dan W. Lin, Funda Vakar-Lopez, Cristina Magi-Galluzzi, and Ryan Berglund John DavisJohn Davis Houston, TX More articles by this author , Patricia TroncosoPatricia Troncoso Houston, TX More articles by this author , Sarah MeyerSarah Meyer San Diego, CA More articles by this author , John DayJohn Day San Diego, CA More articles by this author , Jack GroskopfJack Groskopf San Diego, CA More articles by this author , Sheila AubinSheila Aubin San Diego, CA More articles by this author , Yvonne RodriguezYvonne Rodriguez San Diego, CA More articles by this author , Dan W. LinDan W. Lin Seattle, WA More articles by this author , Funda Vakar-LopezFunda Vakar-Lopez Seattle, WA More articles by this author , Cristina Magi-GalluzziCristina Magi-Galluzzi Cleveland, OH More articles by this author , and Ryan BerglundRyan Berglund Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2280AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies in men scheduled for prostate biopsy or radical prostatectomy (RP) have shown that urine PCA3 levels correlated with positive versus negative biopsies and total tumor volume in RP specimens (Nakanishi et al J Urol 2008). Given the need for novel markers to select patients for active surveillance, we report interim findings from a large, prospective, multi-institutional validation study. METHODS The primary goal was to correlate PCA3 score with well-characterized tumor volume from men undergoing RP. A secondary goal included assessing the additive prediction from a novel urine assay of TMPRSS2:ERG (T2:ERG). Post-DRE urine samples were collected prior to RP. PCA3 mRNA copies were quantified using a transcription-mediated amplification assay and normalized to PSA mRNA copies to calculate a PCA3 score. T2:ERG mRNA copies were quantified and normalized to PSA mRNA copies to calculate a T2:ERG score. PCA3 score, T2:ERG score and serum PSA were assessed individually and combined for their ability to predict prostatectomy indicators of cancer aggressiveness: significant tumor volume (insignificant tumor volume defined as <0.5cc, Gl ≤ 6, and pT2x), pathologic Gleason Score and non-organ confined disease. RESULTS As of 11/1/2011, 250 of 300 planned participants have been enrolled, and 163 subjects have complete data for interim analysis. Insignificant tumor volume was found in 22 (14%) of 163. The AUC analysis showed statistically significant (P<0.05) power to predict insignificant tumor volume for serum PSA (sPSA), PCA3, and T2:ERG0.72, 0.71, and 0.62 respectively. Other AUC analyses demonstrated statistically significant prediction of Gleason score > 6 by all 3 markers, tumor volume > 0.5 for PCA3 and sPSA, and organ confined disease by only sPSA. At a high cutoff of 70, PCA3 predicted 26% of significant cancer at a specificity of 95% while T2:ERG at a cutoff of 160 predicted 22% of significant cancer at a specificity of 100%. Combining PCA3 and T2:ERG at these cutoffs provided 40% (95% CI, 31 - 49%) prediction of significant cancer at 95% specificity (95% CI, 75–100%). In a logarithmic analysis of sPSA, PCA3, and T2:ERG, the prediction of significant cancer was 60% sensitivity at 90% specificity. CONCLUSIONS In an interim analysis of a validation study, PCA3 and T2:ERG show additive prediction of clinically significant tumor volume, that may be useful in the selection and monitoring of active surveillance candidates. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e852-e853 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Davis Houston, TX More articles by this author Patricia Troncoso Houston, TX More articles by this author Sarah Meyer San Diego, CA More articles by this author John Day San Diego, CA More articles by this author Jack Groskopf San Diego, CA More articles by this author Sheila Aubin San Diego, CA More articles by this author Yvonne Rodriguez San Diego, CA More articles by this author Dan W. Lin Seattle, WA More articles by this author Funda Vakar-Lopez Seattle, WA More articles by this author Cristina Magi-Galluzzi Cleveland, OH More articles by this author Ryan Berglund Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...