PCA3 Molecular Urine Assay for Prostate Cancer in Men Undergoing Repeat Biopsy

Marks, Leonard S.; Fradet, Yves; Deras, Ina L.; Blase, Amy; Mathis, Jeannette; Aubin, Sheila M. J.; Cancio, Anthony T.; Desaulniers, M.; Ellis, William; Rittenhouse, Harry G.; Groskopf, Jack

doi:10.1016/j.urology.2006.12.014

Cited by 392 publications

(293 citation statements)

References 12 publications

Supporting

Mentioning

263

Contrasting

Unclassified

Order By: Relevance

“…40 Despite good performance, the uPM3 was withdrawn from the market after introduction of the APTIMA assay (Gen-Probe, San Diego, CA, USA; PROGENSA for European countries) which provides several advantages: (1) The ability to use whole urine and detection of lower concentrations of RNA in clinical samples (as opposed to urine sediments used in methods discussed above); (2) The target capture technology using magnetic particles is more quantitative and user friendly than the RNA extraction methods required for RT-PCR; (3) The APTIMA PCA3 assay can be completed in o6 h, and because of its robustness and reproducibility it can be implemented in the clinical laboratory. 41 Several large studies have confirmed the good performance of this assay, [42][43][44][45][46] and the clinical results have recently been reviewed. 47 The addition of PCA3 to the urologist's diagnostic tools will not result in a state of certainty but the diagnostic sensitivity, specificity and predictive value are incrementally improved by its inclusion.…”

Section: Prostate Cancer Antigenmentioning

confidence: 87%

Urine markers in monitoring for prostate cancer

Jamaspishvili

Král

Khomeriki

et al. 2009

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

The major advantages of urine-based assays are their noninvasive character and ability to monitor prostate cancer with heterogeneous foci. Almost all urine-detectable prostate-specific markers have been recently reviewed. For this reason, we focus here on only a few promising markers which have been independently evaluated (in particular PCA3, fusion genes, TERT, AMACR, GSTP1, MMP9 and VEGF) and very recent ones (ANXA3 and sarcosine). The emphasis is also on multiplex biomarker analysis and on microarray-based analysis of fusion genes. A combination of multiple urine biomarkers may be valuable in the case of men with persistently elevated serum prostatespecific antigen and a history of negative biopsies. The emerging urine tests should help in both early diagnosis of prostate cancer and identifying aggressive tumors for radical treatment.

show abstract

Section: Prostate Cancer Antigenmentioning

confidence: 87%

Urine markers in monitoring for prostate cancer

Jamaspishvili

Král

Khomeriki

et al. 2009

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

“…Marks et al 8 found in 226 patients undergoing repeat biopsy that PCA3 had an AUC of 0.68 for prostate cancer detection, and had superior diagnostic accuracy compared with serum PSA, which had an AUC of 0.52. Haese et al, 9 using data from 463 patients, were able to report comparable diagnostic accuracy of PCA3, with an AUC of 0.66, which was superior to that of percent free The 'all' line shows the net benefit if all patients were taken for repeat prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…The threshold of 35 is commonly used as the optimal cutoff for identifying prostate cancer. 7,8 In univariable analysis, receiver operating characteristic (ROC) curves were created and area under the curve (AUC) was determined.…”

Section: Methodsmentioning

confidence: 99%

“…6 Elevations in PCA3 gene transcripts in post-digital rectal examination (DRE) urine have been shown to be associated with prostate cancer in patients undergoing initial and repeat prostate biopsy. 7 In men undergoing repeat biopsy, studies have suggested that PCA3 may be superior to both PSA 8 and free PSA 9 in predicting the presence of prostate cancer. Furthermore, inclusion of PCA3 improved predictive accuracy of a multivariable model that evaluated probability of having prostate cancer in men with elevated PSA, with or without prior biopsy in a recent study by Chun et al 10 Based on these findings, PCA3 was included in a multivariable nomogram designed to predict the presence of prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

Reese

Cooperberg

et al. 2011

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

BACKGROUND: Men with persistently elevated and/or rising PSA levels after negative prostate biopsy often undergo multiple repeat biopsies. Prostate cancer antigen 3 (PCA3) has emerged as a predictor of prostate cancer. METHODS:We sought to define the utility of PCA3 in combination with other clinical data in predicting the risk of prostate cancer on repeat biopsy. We retrospectively obtained PCA3, PSA, PSA density (PSAD), digital rectal examination (DRE) and transrectal ultrasound (TRUS) findings from 103 patients at a single institution who had at least one prior negative prostate biopsy. The sensitivity and specificity of PCA3 in detecting prostate cancer was determined. Receiver operating characteristics curves were produced for each variable individually and in multivariable analysis, controlling for PCA3, PSAD, TRUS, PSA and DRE. A nomogram was created, internally validated and compared to another recently published nomogram. RESULTS:Of the 103 patients, 37 (31%) had prostate cancer on repeat biopsy. The sensitivity and specificity of PCA3 (using a cut point of 25) was 0.67 and 0.64, respectively. In multivariable analyses, PCA3 was independently associated with prostate cancer (odds ratio: 1.02, 95% confidence interval: 1.01-1.04), with area under the curve (AUC) of 0.64. A multivariable model containing PCA3, PSAD, PSA, DRE and TRUS findings showed the most diagnostic accuracy (AUC: 0.82). CONCLUSIONS:In the setting of prior negative biopsies, PCA3 was independently associated with prostate cancer in a multivariable model. In combination with other clinical data, PCA3 is a valuable tool in assessing the risk of prostate cancer on repeat biopsy.

show abstract

“…In an attempt to improve PSA specificity and reduce the number of unnecessary biopsies many molecular forms of PSA (i.e. free/total PSA, pro-PSA) have been brought into clinical practice, most notably in the presence of PSA values lower than 10 ng/mL; in this light the Prostate Cancer Gene 3 (PCA3) assay (a gene-based marker) has recently been used to select patients for repeated prostate biopsy (5,6). Many authors have reported a significant difference of PCA3 score in patients with positive or negative repeated biopsy (7,8) underlining the lack of sensitivity of PCA3 to prostate volume and prostatitis (7); moreover, the PCA3 score has been incorporated into nomograms to assist in the decision to biopsy assignment of an individual risk of PCa (9).…”

Section: Introductionmentioning

confidence: 99%

PCA3 score and prostate cancer diagnosis at repeated saturation biopsy. Which cut-off: 20 or 35?

et al. 2012

View full text Add to dashboard Cite

ARTIcLE INFO _________________________________________________________ ___________________Purpose: To compare PCA3 score cut-off of 35 vs 20 in PCa diagnosis in patients undergoing repeated saturation prostate biopsy (SPBx). Material and Methods: From January 2010 to May 2011, 118 patients (median 62.5 years) with primary negative extended biopsy underwent a transperineal SPBx (median 30 cores) for persistent suspicion of PCa. The indications for repeated biopsy were: persistently high or increasing PSA values; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA ≤ 25% and ≤ 20%, respectively; moreover, before performing SPBx urinary PCA3 score was evaluated. Results: All patients had negative DRE and median PSA was 8.5 ng/mL (range: 3.7-24 ng/mL). A T1c PCa was found in 32 patients (27.1%): PCA3 score was 59 (median; range: 7-201) in the presence of PCa and 35 (median; in the absence of cancer (p < 0.05). In the presence of ASAP and HGPIN median PCA3 score was 109 (range: 42-253) and 40 (range: 30-140), respectively. Diagnostic accuracy, sensitivity, specificity, PPV and NPV of PCA3 score cut-off of 20 vs 35 in PCa diagnosis were 44.9 vs 50%, 90.6 vs 71.9%, 27.9 vs 41.8%, 31.9 vs 31.5% and 88.9 vs 80%, respectively. ROC analysis demonstrated an AUC for PCA3 ≥ 20 vs ≥ 35 of 0.678 and 0.634, respectively. Conclusions: Our data suggest that PCA3 is more useful as an exclusion tool; moreover, setting a PCA3 cut-off at 20 vs 35, would have avoided 22.9 vs 38.1% of biopsies while missing 9.4% and 28% diagnosis of PCa.

show abstract

PCA3 Molecular Urine Assay for Prostate Cancer in Men Undergoing Repeat Biopsy

Cited by 392 publications

References 12 publications

Urine markers in monitoring for prostate cancer

Urine markers in monitoring for prostate cancer

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

PCA3 score and prostate cancer diagnosis at repeated saturation biopsy. Which cut-off: 20 or 35?

Contact Info

Product

Resources

About