PD19-11 INDIVIDUALIZED PROSTATE CANCER RISK ASSESSMENT BY SERUM PSA, URINE TMPRSS2:ERG AND URINE PCA3 (2014)

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2014PD19-11 INDIVIDUALIZED PROSTATE CANCER RISK ASSESSMENT BY SERUM PSA, URINE TMPRSS2:ERG AND URINE PCA3 Scott Tomlins, John Wei, Sheila Aubin, Sarah Meyer, Petrea Hodge, Jacqueline Aussie, Javed Siddiqui, Robert Lonigro, John Day, Jack Groskopf, and Arul Chinnaiyan Scott TomlinsScott Tomlins More articles by this author , John WeiJohn Wei More articles by this author , Sheila AubinSheila Aubin More articles by this author , Sarah MeyerSarah Meyer More articles by this author , Petrea HodgePetrea Hodge More articles by this author , Jacqueline AussieJacqueline Aussie More articles by this author , Javed SiddiquiJaved Siddiqui More articles by this author , Robert LonigroRobert Lonigro More articles by this author , John DayJohn Day More articles by this author , Jack GroskopfJack Groskopf More articles by this author , and Arul ChinnaiyanArul Chinnaiyan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1530AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Recent recommendations have drawn attention to the limitations of serum PSA as an early detection strategy for prostate cancer (PCa) and advocate individualized decision making. TMPRSS2:ERG (T2:ERG) is a PCa specific gene fusion occurring in ∼50% of PCa foci that is also detectable in urine. Previously, we have demonstrated that urine T2:ERG score determined by a transcription mediated amplification (TMA) assay analogous to the Progensa PCA3 TMA assay is highly correlated to total tissue TMPRSS2:ERG+ PCa burden. Similarly, an initial version of the T2:ERG TMA assay, in combination with urine PCA3 score, improved on PSA for predicting PCa on biopsy (bx). Here we assessed the performance of a final, clinical grade urine T2:ERG assay. Methods Trained logistic regression models incorporating serum PSA (or the prostate cancer prevention risk calculator [PCPTrc]), urine T2:ERG score and urine PCA3 score for predicting PCa risk on bx were assessed in a validation cohort of prospectively collected post-DRE urine specimens from 1,244 men. Similarly trained models for predicting high grade (Gleason score >6) PCa risk on bx were also assessed. Results Among 1,225 informative validation cohort patient urine specimens (98%), models incorporating T2:ERG score had significantly greater area under the curve (AUC) than PSA or PCPTrc alone for predicting PCa (PSA: 0.666 vs. 0.585, PCPTrc: 0.717 vs. 0.639, both P<0.001) or high grade PCa on bx (PSA: 0.729 vs. 0.651, P<0.001; high grade PCPTrc: 0.754 vs. 0.707, P<0.006). Models incorporating T2:ERG score had significantly greater AUC than models incorporating only PSA (or PCPTrc)+PCA3 for predicting PCa (PSA: 0.751 vs. 0.712, PCPTrc: 0.761 vs. 0.739, both P<0.001) or high grade PCa on bx (PSA: 0.772 vs. 0.747, high grade PCPTrc: 0.779 vs. 0.752, both P<0.001). Models were well calibrated in the validation cohort. Conclusions In the largest validation study to date of urine T2:ERG, risk models incorporating T2:ERG+PCA3+PSA (or PCPTrc) significantly improved upon PSA (or PCPTrc) alone for predicting PCa and high grade PCa on bx. A combined test, termed Mi-Prostate Score (MiPS), is clinically available to provide individualized risk estimates to patients. MiPS∗ risk % bin n (% of total) Median MiPS∗ risk % Median PCPTrc risk % Actual PCa risk 0-10% 77 (7%) 7% 31% 8% 10-25% 267 (23%) 17% 36% 19% 25-50% 344 (30%) 37% 39% 36% 50-75% 276 (24%) 64% 43% 54% >75% 202 (17%) 85% 55% 79% ∗ MiPS risk model incorporating PCPTrc+T2:ERG+PCA3. Data from all informative validation cohort specimens from patients with all PCPTrc required information. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e549-e550 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Scott Tomlins More articles by this author John Wei More articles by this author Sheila Aubin More articles by this author Sarah Meyer More articles by this author Petrea Hodge More articles by this author Jacqueline Aussie More articles by this author Javed Siddiqui More articles by this author Robert Lonigro More articles by this author John Day More articles by this author Jack Groskopf More articles by this author Arul Chinnaiyan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...