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A new prostate cancer test might eliminate the need for unneeded biopsies


According to a validation study including more than 1,500 patients, a urine test based on University of Michigan Rogel Cancer Center research might have saved one-third of needless prostate cancer biopsies while missing just a tiny percentage of tumors. The results will be published in the March edition of the Journal of Urology.

LynxDX, a U-M startup firm, is commercializing the MyProstateScore test, which evaluates levels of cancer-specific genes in a patient’s urine. It is based on research from the University of Michigan that revealed that 50% of all prostate cancers had a genetic abnormality in which the genes TMPRSS2 and ERG move on a chromosome and fuse together, producing an on-switch for prostate cancer growth.

A blood test for prostate-specific antigen, often known as the PSA test, is now one of the finest tools available to clinicians for identifying prostate cancer. Although increased PSA values may suggest malignancy, the vast majority of men with elevated PSA levels do not have prostate cancer.

Men with a high PSA test undergo an invasive treatment called a transrectal biopsy to establish who has cancer and who does not. Patients experience discomfort during prostate biopsies, and there is a small risk of complications. MRI scans are also used to identify prostate cancer, although they may miss malignant tumours and are far more expensive and scarce.

“Our ultimate goal was to see if the MyProstateScore test could be a practical, reliable test that could eliminate the need for more expensive or invasive testing in men referred for a prostate biopsy,” says study lead author Jeffrey Tosoian, M.D., M.P.H., a clinical lecturer in urology at Michigan Medicine.

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Tosoian and two of his co-authors founded LynxDX and have a share in the firm.

Not all prostate cancers have the same level of concern. Many appear later in life and develop so slowly that the best course of action is just to keep an eye on them. Patients with slow-growing malignancies or no cancer, despite increased PSA levels, might be saved from more invasive or costly treatments, according to the study.

Patients seen in academic health facilities and community health settings were included in the validation research. Among the 1,525 patients, 338 (22%) had tumors found on biopsy that were group grade 2 or above, indicating that they were dangerous enough to need rapid treatment.

The research discovered that if the MyProstateScore test had been accessible to participants in the trial, 387 biopsies that revealed no cancer or slow-growing cancer may have been avoided. Meanwhile, the test would have missed just ten clinically severe tumors that required rapid treatment.

“The statistics demonstrate that this simple, secondary testing strategy might minimize the utilization of more expensive and invasive treatments after a PSA test,” Tosoian adds.

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