Highlights of 2013; New Urine Test for Prostate Cancer.

A new urine test for prostate cancer that measures minute fragments of ribonucleic acid (RNA) is now commercially available nationwide through the University of Michigan MLabs. The new test [Mi-Prostate Score (MiPS)], improves the utility of the PSA blood test, increases physicians’ ability to differentiate high-risk prostate tumors from low-risk tumors in patients, and may help many men avoid unnecessary biopsies. While there are currently no perfect biomarkers that identify only high-risk prostate cancer, the MiPS test incorporates blood PSA levels and two molecular RNA biomarkers specific for prostate cancer in one final score that provides men and their doctors with a more personalized prostate cancer risk assessment. One biomarker is a snippet of RNA made from a gene (PCA3) that is overactive in 95 percent of all prostate cancers. The second biomarker is RNA that is made only when two genes (TMPRSS2 and ERG) abnormally fuse. The presence of this fusion RNA in a man’s urine is very specific for prostate cancer. A commercial urine test (PROGENSA PCA3) for PCA3, developed and marketed by the California-based biotech company Gen-Probe, gained FDA approval in 2012 for use in men who are considering repeat biopsy after an initially negative result. The new urine test offered by MLabs that measures both PCA3 and TMPRSS2:ERG should improve a doctor’s ability to stratify men suspected of having prostate cancer. In a study published in Science Translational Medicine, University of Michigan investigators found a correlation between the highest rates of cancer in men with the highest levels of TMPRSS2:ERG and PCA3 in their urine. The men in the study were divided into three groups based upon the levels of TMPRSS2:ERG and PCA3 in their urine: low, intermediate and high levels. Cancer was diagnosed in each of the groups respectively: 21%, 43%, and 69%. High-grade prostate cancer, defined in the study as a Gleason score greater than 6, also occurred at different frequencies in the three groups with 7%, 20%, and 40% diagnosed in each group respectively. For additional information on this test, see the following link from the December 20th, 2013 Prostate Cancer Foundation Newsletter. Earlier references to these tests can also be found on this website in 2013 posts dated October 8th,  and July 16th as well as those dated March 25th, 2012 and September 21st, 2011

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