Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer

Loeb, Stacy; Shin, Sanghyuk S.; Broyles, Dennis L.; Wei, John T.; Sanda, Martin G.; Klee, George G.; Partin, Alan W.; Sokoll, Lori J.; Chan, Daniel W.; Bangma, Chris H.; Schaik, Ron H.N. van; Slawin, Kevin M.; Marks, Leonard S.; Catàlona, William J.

doi:10.1111/bju.13676

Cited by 79 publications

(62 citation statements)

References 24 publications

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“…79,80 Additionally, in a large, multicentre, prospective study, PHI significantly improved the performance of the PCPT and ERSPC risk calculators (see below) in men with a PSA between 2 and 10 ng/ml for predicting the risk of Gleason ≥7 prostate cancer. 81 A multicentre cohort study evaluating the clinical utility of PHI found that it reduced unnecessary biopsies by 36% and only missed 2.5% of highgrade cancers. 80 When comparing PHI and the 4K score, the two tests appear to demonstrate similar discriminatory ability in predicting high-risk prostate cancer in men with a PSA between 3 and 15 ng/ml (AUC 4Kscore 0.718 vs. PHI 0.711).…”

Section: Prostate Health Index (Phi ® )mentioning

confidence: 99%

Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Rendon¹,

Mason

Marzouk³

et al. 2017

CUAJ

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Section: Prostate Health Index (Phi ® )mentioning

confidence: 99%

Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Rendon¹,

Mason

Marzouk³

et al. 2017

CUAJ

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“…[19, 20, 33, 34] As an example, adding PHI to the PCPT-RC or ERSPC-RC improves the predictive accuracy of aggressive disease. [35]…”

Section: Determining the Need For Prostate Biopsymentioning

confidence: 99%

Improving the evaluation and diagnosis of clinically significant prostate cancer in 2017

Carlsson

Roobol

2017

Current Opinion in Urology

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Purpose of review To provide an overview of the current state of the evidence and highlight recent advances in the evaluation and diagnosis of clinically significant prostate cancer, focusing on biomarkers, risk calculators and mpMRI. Recent findings In 2017, there are numerous options to improve early detection as compared to a purely PSA-based approach. All have strengths and drawbacks. In addition to repeating the PSA and performing clinical work-up (DRE and estimation of prostate volume), additional tests investigated in the initial biopsy setting are: %free PSA, PHI, 4Kscore, SelectMDx and MiPS and in the repeat setting: %free PSA, PHI, 4Kscore, PCA3, and ConfirmMDx. Risk calculators are available for both biopsy settings and incorporate clinical data with, or without, biomarkers. mpMRI is an important diagnostic adjunct. Summary There are numerous tests available that can help increase the specificity of PSA, in the initial and repeat biopsy setting. All coincide with a small decrease in sensitivity of detecting high-grade cancer. Cost effectiveness is crucial. The way forward is a multivariable risk assessment on the basis of readily available clinical data, potentially with the addition of PSA subforms, preferably at low cost. MRI in the pre-diagnostic setting is promising, but is not ready for “prime time”.

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“…More recently, Loeb et al developed a new nomogram using phi with other variables to predict clinically significant PCa. (27)…”

Section: Blood Biomarkersmentioning

confidence: 99%

The role of prostate cancer biomarkers in undiagnosed men

Dani

Loeb²

2017

Current Opinion in Urology

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Purpose of review This article intends to review biomarkers derived from blood, urine, and tissue that can aid in the diagnosis of prostate cancer. Recent findings Prostate cancer (PCa) screening requires tools that complement prostate-specific antigen (PSA) with a higher specificity for clinically significant disease. Novel blood biomarkers, such as the prostate health index and 4Kscore, utilize isoforms of PSA to more accurately predict high-grade PCa than traditional tools such as PSA and the percentage free-to-total PSA. Several gene products associated with PCa can be detected in the urine through commercially available assays. Prostate cancer antigen 3 (PCA3), though approved for repeat biopsy decisions, appears inferior to other biomarkers such as phi for identifying aggressive disease. However, combinations of PCA3 with other urine assays have shown promising results. One tissue-based hypermethylation test, named ConfirmMDx, can also be used to determine the need for repeat biopsy in men with a prior negative biopsy. Summary Several biomarkers have been developed to aid in the screening and diagnosis of PCa. Such tests are often indicated in men with moderately elevated PSA or history of a prior negative biopsy. Their use facilitates reduction of unnecessary biopsies without sacrificing the early diagnosis of clinically significant PCa.

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Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer

Cited by 79 publications

References 24 publications

Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Improving the evaluation and diagnosis of clinically significant prostate cancer in 2017

The role of prostate cancer biomarkers in undiagnosed men

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