April 27, 2024

Breakthrough urine test could help men avoid unnecessary prostate biopsies

By Sola Ogundipe

A new urine test for prostate cancer detection is showing promise. The current standard test, the Prostate Specific Antigen, PSA, isn’t very accurate at distinguishing between aggressive and slow-growing cancers.

Published in JAMA Oncology, this new test, called MyProstateScore2.0 (MPS2), analyzes 18 genes linked to aggressive prostate cancer.

This could help differentiate between slow-growing, low-risk cancers and fast-growing cancers that require treatment, potentially reducing unnecessary biopsies.

Researchers at the University of Michigan Rogel Cancer Center say the new urine test may significantly improve prostate cancer diagnosis.  “The game changed,” said co-senior author John T. Wei, M.D. “We now realize slow-growing cancer doesn’t need treatment. MPS2 improves upon a previous urine test by analyzing more genes specifically linked to aggressive cancers.”

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To make MPS2 test even stronger at identifying high-grade cancers, researchers used RNA sequencing of more than 58,000 genes and narrowed it to 54 candidates uniquely overexpressed specifically in higher-grade cancers. They tested the biomarkers against urine samples collected and stored at U-M through another major study, the National Cancer Institute’s Early Detection Research Network. This included about 700 patients from 2008-2020 who came for a prostate biopsy due to an elevated PSA level.

Researchers developed a multi-step process to refine the MPS2 test. First, they narrowed down potential markers to 18 that consistently correlated with aggressive prostate cancer. The final test incorporates the original MPS markers alongside these 16 additional biomarkers for a more comprehensive analysis.

To ensure the test’s effectiveness across a diverse population, the research team collaborated with the Early Detection Research Network (EDRN), a nationwide consortium of labs. They anonymously analyzed over 800 urine samples from EDRN and compared MPS2 results with patient records. The analysis showed that MPS2 was significantly better at identifying high-grade prostate cancers and nearly perfect at ruling out low-grade cancers.

“If you’re negative on this test, it’s almost certain that you don’t have aggressive prostate cancer,” said Chinnaiyan, S. P. Hicks Endowed Professor of Pathology and professor of urology at Michigan Medicine.