MP26-12 USE OF THE MYPROSTATESCORE (MPS) TEST FOR RISK STRATIFICATION IN MEN WITH A PREVIOUS NEGATIVE BIOPSY: INITIAL VALIDATION OF A STRAIGHTFORWARD TESTING APPROACH

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (MP26)1 Sep 2021MP26-12 USE OF THE MYPROSTATESCORE (MPS) TEST FOR RISK STRATIFICATION IN MEN WITH A PREVIOUS NEGATIVE BIOPSY: INITIAL VALIDATION OF A STRAIGHTFORWARD TESTING APPROACH Michael Sessine, Todd Morgan, John Wei, Simpa Salami, Ganesh Palapattu, Bruce Trock, Ashley Ross, Joshua Cabral, Gary Longton, Yingye Zheng, Scott Tomlins, Lakshmi Kunju, Javed Siddiqui, Yashar Niknafs, Arul Chinnaiyan, and Jeff Tosoian Michael SessineMichael Sessine More articles by this author , Todd MorganTodd Morgan More articles by this author , John WeiJohn Wei More articles by this author , Simpa SalamiSimpa Salami More articles by this author , Ganesh PalapattuGanesh Palapattu More articles by this author , Bruce TrockBruce Trock More articles by this author , Ashley RossAshley Ross More articles by this author , Joshua CabralJoshua Cabral More articles by this author , Gary LongtonGary Longton More articles by this author , Yingye ZhengYingye Zheng More articles by this author , Scott TomlinsScott Tomlins More articles by this author , Lakshmi KunjuLakshmi Kunju More articles by this author , Javed SiddiquiJaved Siddiqui More articles by this author , Yashar NiknafsYashar Niknafs More articles by this author , Arul ChinnaiyanArul Chinnaiyan More articles by this author , and Jeff TosoianJeff Tosoian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002023.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The MyProstateScore (MPS) test incorporates prostate cancer antigen 3 (PCA3) and the TMPRSS2:ERG gene fusion (T2:ERG) with serum PSA to better define risk of Grade Group (GG) ≥2 cancer on biopsy. We previously validated use of MPS as a rule-out test with 98% negative predictive value (NPV) in biopsy-naïve men. We sought to identify a straightforward testing approach for risk stratification in patients with a previous negative biopsy. METHODS: All patients provided post-digital rectal examination urine prior to biopsy. MPS was calculated using the validated, locked multivariable model including serum PSA, urinary PCA3, and urinary T2:ERG and reported on a continuous scale from 0 (very unlikely to detect GG≥2 cancer) to 100 (very likely to detect GG≥2 cancer). The MPS values approximating ≤5% risk of GG≥2 cancer (lower threshold) and ≥20% risk of GG≥2 cancer (upper threshold) were identified in a primary cohort, and performance was measured in an external validation cohort. RESULTS: The primary cohort included 422 men of median age 66 years (IQR 61–72), PSA 6.4 ng/ml (4.3-9.1), and MPS 23.1 (13.0-38.4). On repeat biopsy, 58 men (14%) were found to have GG≥2 cancer. MPS thresholds of 15 and 40 were identified in this cohort and applied to the external validation cohort of 268 men of median age 64 years (59-69), PSA 7.6 ng/ml (5.5-10.6), and MPS 28.9 (16.9-49.2). Twenty-five men (9.3%) in the validation cohort were found to have GG≥2 cancer. Test performance and clinical outcomes based on applying each threshold to the validation cohort are listed in Table 1. Notably, use of MPS≤15 to rule out biopsy would have avoided 21% of biopsies with 100% NPV. Meanwhile, MPS≤40 would have avoided 67% of biopsies with 95% NPV. CONCLUSIONS: Men with persistently elevated PSA following negative biopsy present a clinical challenge. We herein identified and validated MPS thresholds to accurately rule-out the need for repeat biopsy. Given the limited prevalence of GG≥2 cancer in the repeat-biopsy population, additional data are needed to confirm these findings and to characterize use of MPS in combination with diagnostic imaging such as mpMRI . Source of Funding: Early Detection Research Network (EDRN), National Cancer Institute, Rogel Cancer Center Medical Student Scholarship © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e467-e467 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Sessine More articles by this author Todd Morgan More articles by this author John Wei More articles by this author Simpa Salami More articles by this author Ganesh Palapattu More articles by this author Bruce Trock More articles by this author Ashley Ross More articles by this author Joshua Cabral More articles by this author Gary Longton More articles by this author Yingye Zheng More articles by this author Scott Tomlins More articles by this author Lakshmi Kunju More articles by this author Javed Siddiqui More articles by this author Yashar Niknafs More articles by this author Arul Chinnaiyan More articles by this author Jeff Tosoian More articles by this author Expand All Advertisement Loading ...