Revolutionary Urine Test Offers Accurate Detection of Aggressive Prostate Cancer

Breakthrough Urine Test Detects Deadliest Forms of the Disease with Unparalleled Accuracy

In a breakthrough for prostate cancer diagnosis, researchers have developed a novel urine test that can accurately identify clinically significant prostate cancers while avoiding unnecessary biopsies. The test, called MyProstateScore 2.0 (MPS2), measures the expression of 18 genes associated with prostate cancer and has shown remarkable accuracy in detecting worrisome cases of the disease.

The findings, published in the prestigious JAMA Oncology journal, have the potential to revolutionize the way prostate cancer is diagnosed and managed, offering a less invasive and more precise approach than current methods.

"This new test is a game-changer," said Dr. Jeffrey Tosoian, the study's lead author and a urologist at Vanderbilt University Medical Centre. "In nearly 800 patients with an elevated PSA level, MPS2 was able to rule out the presence of clinically significant prostate cancer with remarkable accuracy. This means patients can avoid more burdensome and invasive tests, like MRI and prostate biopsy, with great confidence that we are not missing something serious."

Prostate cancer is the most common cancer and the second leading cause of cancer death among men in the United States. While the PSA blood test has been widely used for screening, it often leads to false positives, resulting in numerous unnecessary biopsies. Prostate biopsies, although generally safe, are invasive, uncomfortable, and carry some risk of complications.

The MPS2 test was developed to specifically detect higher-grade, clinically significant cancers that require early detection and treatment, while avoiding overdiagnosis and overtreatment of low-risk cases that can be safely monitored through active surveillance.

By analysing prostate tumours from across the U.S., the research team identified novel genes more often detected in the presence of significant cancers. The most informative 18 genes were combined into the MPS2 test, which was then evaluated in a National Cancer Institute trial of men with an elevated PSA level.

The results were impressive. While existing biomarker tests could have avoided 15% to 30% of unnecessary biopsies, the use of MPS2 would have avoided 35% to 42% of unnecessary biopsies without missing any additional diagnoses of clinically significant cancer. The improvement was even more pronounced in men with a history of a previous negative biopsy, reducing the rate of unnecessary biopsies from 46% to 51% with the use of MPS2, compared to 9% to 21% for existing tests.

"The externally validated performance of MPS2 supports its effectiveness in accurately ruling out the need for MRI and biopsy altogether," said Dr. Tosoian.

While multiparametric magnetic resonance imaging (mpMRI) is another second-line test used for prostate cancer detection, the authors noted that it can be subjective and varies significantly in interpretation. Additionally, mpMRI is not available in some community settings and is not an option for some patients.

The researchers acknowledged a limitation of the study was that only 13% of participants were African American, as prostate cancer is more prevalent among this population. However, they are currently pursuing further analyses in more racially diverse populations.

With its potential to reduce unnecessary biopsies and accurately detect clinically significant prostate cancers, the MPS2 urine test represents a significant step forward in the fight against one of the most common and deadly cancers affecting men.