MP55-14 IsoPSA PERFORMANCE CHARACTERISTICS ARE NOT IMPACTED BY 5-ALPHA REDUCTASE INHIBITORS OR ALPHA-BLOCKERS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP55-14 IsoPSA PERFORMANCE CHARACTERISTICS ARE NOT IMPACTED BY 5-ALPHA REDUCTASE INHIBITORS OR ALPHA-BLOCKERS Jason Scovell, Mark Stovsky, Aimee Kestranek, and Eric Klein Jason ScovellJason Scovell More articles by this author , Mark StovskyMark Stovsky More articles by this author , Aimee KestranekAimee Kestranek More articles by this author , and Eric KleinEric Klein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003308.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: IsoPSA is a structure-based test linked to tumor biology that has demonstrated improved performance characteristics over PSA and percent free PSA to identify clinically actionable prostate cancer (GG2+). Medications for benign prostatic hyperplasia (BPH) including 5-α reductase inhibitors (5ARIs) and α-blockers are commonly used in the patient population undergoing prostate cancer screening. The relationship between 5-ARIs and PSA levels is well established. We sought to determine the impact that common BPH medications have on IsoPSA performance. METHODS: This is a secondary analysis of data from an institutional review board (IRB) approved, prospective, multicenter study evaluating IsoPSA in men≥50 years of age with a total PSA ≥ 4ng/ml with planned prostate biopsy who met previously described inclusion/exclusion criteria. Analytic groups included (i) all subjects, (ii-iii) +/- 5-ARI use, (iv-v) +/- α-blocker use. Sensitivity and specificity analysis were performed and receiver operating curves (ROC) were evaluated. RESULTS: A total of 1,385 men were recruited from a multi-center (8 sites), prospective, nonrandomized cohort with 888 men included in final analysis. Actionable prostate cancer, defined as GG2 or greater, was identified in a total of 316 patients (35.6%). In this cohort, 40 patients reported 5-ARI use and 217 reported α-blocker use. At the pre-determined IsoPSA threshold (5.25 all cancer; 6.0 GG2+) sensitivity to detect both all prostate cancer and actionable cancer was similar between all patients enrolled and patients on either 5-ARIs or α-blockers (All: 0.90 vs 5-ARI: 0.94 vs α-blocker: 0.85; p>0.05). Specificity was similar between patients regardless of 5-ARI (No 5-ARI: 0.46 vs 5-ARI: 0.45, p>0.05). Increased specificity was noted in patients on α-blockers (No α-blocker: 0.40 vs α-blocker: 0.61, p<0.05). There were no additional differences in FP, FN, FP, FN, LR (+/-), PPV, or NPV rates between all sub-cohorts. ROC analysis demonstrates excellent performance of IsoPSA regardless of 5-ARI or α-blocker use for both the detection of all prostate cancer and for actionable cancer (Figure 1). CONCLUSIONS: Common BPH medications (5-ARI and α-blockers) do not negatively impact IsoPSA performance characteristics for the detection of prostate cancer including clinically actionable prostate cancer. Source of Funding: Cleveland Diagnostics funded the initial study of IsoPSA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e769 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jason Scovell More articles by this author Mark Stovsky More articles by this author Aimee Kestranek More articles by this author Eric Klein More articles by this author Expand All Advertisement PDF downloadLoading ...