PD44-07 EFFECTIVENESS OF SERUM PSA, URINE PCA3 AND URINE TMPRSS2:ERG FUSION AS A NOVEL URINARY BIOMARKER PANEL IN CLINICAL PRACTICE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 2015PD44-07 EFFECTIVENESS OF SERUM PSA, URINE PCA3 AND URINE TMPRSS2:ERG FUSION AS A NOVEL URINARY BIOMARKER PANEL IN CLINICAL PRACTICE John Wei, Javed Siddiqui, Rabia Siddiqui, Arul M. Chinnaiyan, Lakshmi P. Kunju, Rohit Mehra, Debbie Snyder, and Scott A. Tomlins John WeiJohn Wei More articles by this author , Javed SiddiquiJaved Siddiqui More articles by this author , Rabia SiddiquiRabia Siddiqui More articles by this author , Arul M. ChinnaiyanArul M. Chinnaiyan More articles by this author , Lakshmi P. KunjuLakshmi P. Kunju More articles by this author , Rohit MehraRohit Mehra More articles by this author , Debbie SnyderDebbie Snyder More articles by this author , and Scott A. TomlinsScott A. Tomlins More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2553AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES When new technology enters clinical practice, effectiveness deviates from efficacy due to external patient, provider, and systems related factors that may moderate its effect. PCA3, a prostate-specific noncoding gene that is significantly over-expressed in cancer and TMPRSS2(T2):ERG, a prostate cancer specific gene fusion, are both quantifiable by urinary assays that along with serum PSA comprise the testing panel Michigan Prostate Score (MiPS). This novel panel reports individual patient risk estimates for biopsy detection of any prostate cancer (MiPS) and high grade (Gleason score >6) cancer (HG MiPS). We examined the impact of this new test panel on clinical decision-making in men without cancer who were presenting for a prostate biopsy. METHODS During the past year, men referred for prostate biopsy at a single institution were offered MiPS as an alternative to proceeding directly to a biopsy. Patient characteristics, PSA, PCA3, T2:ERG, and biopsy pathology were analyzed to see how MiPS and HG MiPS affected the decision for prostate biopsy and pathology at biopsy. One-way ANOVA was used to compare PCA3, T2:ERG and risk levels. RESULTS 121 men (21.5% with prior biopsy) underwent MiPS testing with a mean age of 64 years, median PSA of 7 ng/ml, PCA3 score of 22, T2:ERG score of 2. Based on MiPS, the average predicted risk for detection of any and high grade cancer were 42.4% and 26.6%, respectively. Men who then chose to have a biopsy (n=58/47.9%) had higher MiPS (54.1% vs 31.6%, p<0.05) and HG MiPS scores (35.3% vs 18.5%, p<0.05) than those who did not. Among those biopsied, MiPS, HG MiPS, PCA3, T2:ERG were higher in those with high grade cancer found on biopsy but only T2:ERG was significantly higher (178.2 vs 44.5, p<0.05). CONCLUSIONS The combination of PSA, PCA3 and T2:ERG as a test panel for prostate cancer reduced the use of prostate biopsy in half. T2:ERG was strongly associated with detection of high grade cancer. These findings support the use of MiPS for assessing prostate cancer risk. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e899-e900 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Wei More articles by this author Javed Siddiqui More articles by this author Rabia Siddiqui More articles by this author Arul M. Chinnaiyan More articles by this author Lakshmi P. Kunju More articles by this author Rohit Mehra More articles by this author Debbie Snyder More articles by this author Scott A. Tomlins More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...