NIH-supported researchers enhance urine tests for prostate cancers

An NIH-supported research team led by Arul M. Chinnaiyan, MD, PhD, Director of the Michigan Center for Translational Pathology, expanded on previous efforts on a urine-based test called MyProstateScore (MPS). The research efforts for developing and validating an 18-gene urine test for high-grade prostate cancer were detailed in an article for JAMA Oncology.

According to the American Cancer Society, across the United States, there are an estimated 299,010 new prostate cancer cases annually. Additionally, there are roughly 35,250 prostate cancer deaths yearly, contributing to the 1 in 44 men who die of prostate cancer.

Traditional screening for prostate cancer involves a blood test that detects elevated levels of prostate-specific antigens (PSA) produced by the prostate glands. Elevated levels are typically indicative of prostate cancer or other prostate-related conditions. However, patients with elevated PSA levels may be referred for additional testing, including a biopsy.

While biopsies are safe and effective, they may be painful and unnecessary for some conditions. The NIH press release notes that most biopsies identify slow-growing cancers that do not require immediate treatment and may only need close monitoring.

Researchers and healthcare professionals are looking for noninvasive ways to differentiate between aggressive and slow-growing cancers to mitigate the potential risks associated with biopsies and reduce the number of unnecessary biopsies.

Chinnaiyan and his team explored 59,000 genes and identified 54 candidate markers for this gene-based urine test. After baseline gene analysis, researchers analyzed 761 patients to narrow down the genes to 17 that could predict the presence of high-grade cancer. An additional gene associated with general prostate tissue was added to the test to develop the 18-gene test called MyProstateScore 2.0 (MPS2).

To validate the test, MPS2 was used to analyze urine samples for 743 men who had been biopsied due to high PSA scores. According to the validation, MPS2 is 97% accurate at detecting the presence of high-grade cancers, with better results than the original MPS test.

Additionally, they estimate that 51% of unnecessary biopsies could be avoided with MPS2.

“In nearly 800 patients with an elevated PSA level, the new test was capable of ruling out the presence of clinically significant prostate cancer with remarkable accuracy,”  Jeffrey Tosoian, MD, MPH, another study leader, said in the NIH press release. “This allows patients to avoid more burdensome and invasive tests, like MRI and prostate biopsy, with great confidence that we are not missing something.”