Prostate cancer: the value of combined urinary T2:ERG and PCA3 testing

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Takeaway
  • Combined urinary testing for the 2 prostate cancer (PCa)-associated RNA markers, T2:ERG and PCA3, improved specificity of predicting aggressive PCa compared with prostate-specific antigen (PSA). 
  • 42% of unnecessary prostate biopsies would have been averted by using combined urinary testing.

Why this matters

  • Serum PSA has low specificity for detecting aggressive PCa at PSA levels that have sufficient sensitivity. 
  • Combined T2:ERG and PCA3 testing can avert unnecessary biopsy while retaining robust sensitivity for detecting aggressive PCa, which offers potential healthcare cost savings.

Study design

  • Urinary RNA parameters that improve specificity for predicting PCa were identified in the developmental cohort (n=516) and confirmed in a validation cohort (n=561).
  • Funding: NIH.

Key results

  • In the developmental cohort, T2:ERG and PCA3 scores >60 were each significantly associated with aggressive PCa (P for both<.001), and combining T2:ERG with PCA3 testing showed specificity of 39% in predicting aggressive PCa; PSA had a specificity of 18%.
  • In the validation cohort, 42% of unnecessary biopsies would have been averted in patients with negative T2:ERG and PCA3 findings.

Limitations

  • Repeat testing was not evaluated.


Coauthored with Deepa Koli, MPharm