MP30-11 CLINICAL UTILITY OF EXOSOMEDX WHEN COMBINED WITH PSA, TRUS AND MPMRI FOR THE DETECTION OF HIGH-GRADE PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP30)1 Sep 2021MP30-11 CLINICAL UTILITY OF EXOSOMEDX WHEN COMBINED WITH PSA, TRUS AND MPMRI FOR THE DETECTION OF HIGH-GRADE PROSTATE CANCER Claire de la Calle, Vittorio Fasulo, Martina Maggi, Nicolò Buffi, Matthew Cooperberg, Peter Carroll, Katsuto Shinohara, and Hao Nguyen Claire de la CalleClaire de la Calle More articles by this author , Vittorio FasuloVittorio Fasulo More articles by this author , Martina MaggiMartina Maggi More articles by this author , Nicolò BuffiNicolò Buffi More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Peter CarrollPeter Carroll More articles by this author , Katsuto ShinoharaKatsuto Shinohara More articles by this author , and Hao NguyenHao Nguyen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002027.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: How to integrate liquid biomarkers for prostate cancer (PCa) screening has not been clearly defined. We aimed to determine number of biopsies avoided and missed high-grade PCa using urine-based biomarker ExosomeDx when combined with prostate specific antigen density (PSAD), transrectal ultrasonography (TRUS) and multiparametric magnetic resonance imaging (mpMRI). METHODS: Patients referred to our institution between 2016 and 2019 with elevated PSA were retrospectively reviewed. High-grade PCa was defined as Gleason grade group (GG) ≥2. The frequency of potentially avoided biopsies was determined as the number of negative tests divided by the total cohort. The frequency of potentially missed GG≥2 PCa was determined as the number of false negative tests divided by all high-grade diagnoses in the cohort of biopsied patients. RESULTS: Of the 369-patient cohort, 334 (90.5%) had a TRUS and PSAD, 274 (74.3%) had a mpMRI, and 167 (45.3%) underwent prostate biopsy. Median age was 64.9 years (IQR 60.0–70.7), median PSA 7.01 ng/ml (IQR 5.00–9.90), and median ExosomeDx score 21.3 (IQR 12.3–37.0). ExosomeDx score higher than manufacturer cutoff (≥15.6) was associated with PI-RADS scores 3-5 (p<0.001), and GG≥2 PCa (p<0.001). Combining ExosomeDx with mpMRI would have resulted in avoiding 18.6–23.7% unnecessary biopsies overall, while missing only 3.23–4.84% GG≥2 PCa in those biopsied. Combining ExosomeDx with PSAD or TRUS clinical staging however would have also resulted in avoiding 22.2–22.5% unnecessary biopsies overall while only 1.47–1.54% GG≥2 PCa in the biopsy group would have been missed. Finally combining ExosomeDx with PSAD and mpMRI would have resulted in missing zero GG≥2 PCa in those biopsied but only 11.0–13.6% biopsies overall would have been avoided (Table 1). CONCLUSIONS: In our clinical practice combining ExosomeDx with PSAD, TRUS and/or mpMRI would have resulted in missing very few clinically significant PCas while still avoiding unnecessary biopsies. ExosomeDx combined with PSAD and/or TRUS would have missed very few clinically significant PCas without the need for mpMRI. Such screening algorithms are likely already widely used in clinical practice and should be validated with prospective trials. Source of Funding: UCSF Goldberg-Benioff Program in Cancer Translational Biology © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e503-e504 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claire de la Calle More articles by this author Vittorio Fasulo More articles by this author Martina Maggi More articles by this author Nicolò Buffi More articles by this author Matthew Cooperberg More articles by this author Peter Carroll More articles by this author Katsuto Shinohara More articles by this author Hao Nguyen More articles by this author Expand All Advertisement Loading ...