Urinary MyProstateScore (MPS) to Rule out Clinically-Significant Cancer in Men with Equivocal (PI-RADS 3) Multiparametric MRI: Addressing an Unmet Clinical Need

Tosoian, Jeffrey J.; Singhal, Udit; Davenport, Matthew S.; Wei, John T.; Montgomery, Jeffrey S.; George, Arvin; Salami, Simpa S.; Mukundi, Stanley; Siddiqui, Javed; Kunju, Lakshmi P.; Tooke, Benjamin P.; Ryder, C. Yoonhee; Dugan, Sarah P.; Chopra, Zoey; Botbyl, Rachel; Feng, Yilin; Sessine, Michael; Eyrich, Nicholas W.; Ross, Ashley E.; Trock, Bruce J.; Tomlins, Scott A.; Palapattu, Ganesh S.; Chinnaiyan, Arul M.; Niknafs, Yashar S.; Morgan, Todd M.

doi:10.1016/j.urology.2021.11.033

Cited by 16 publications

(12 citation statements)

References 38 publications

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“…A combination screening method using mpMRI and PC biomarkers offers a promising solution to this problem. Tosoian et al conducted a similar study to ours using the urinary MyProstateScore (MPS), concluding that MPS significantly outperforms PSA and PSA‐density testing in ruling out GG2+ cancer in men with equivocal mpMRI results 12 . Other studies outside our own have examined the benefits of combining mpMRI and 4Kscore in various combinations 13,14 .…”

Section: Discussionmentioning

confidence: 62%

“…Tosoian et al conducted a similar study to ours using the urinary MyProstateScore (MPS), concluding that MPS significantly outperforms PSA and PSA‐density testing in ruling out GG2+ cancer in men with equivocal mpMRI results. 12 Other studies outside our own have examined the benefits of combining mpMRI and 4Kscore in various combinations. 13 , 14 However, to our knowledge, this is the first study to evaluate the best 4Kscore threshold for considering a biopsy of the prostate in men with a negative or equivocal mpMRI.…”

Section: Discussionmentioning

confidence: 99%

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Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging

Thomas

Mason

et al. 2023

BJUI Compass

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ObjectiveThe study aims to identify the optimal 4Kscore thresholds to determine the need for a prostate biopsy when multiparametric magnetic resonance imaging (MRI) (mpMRI) is negative or indeterminate.Materials and methodsWe analysed retrospective data from men in eight different institutions who underwent an mpMRI, 4Kscore and prostate biopsy for evaluation of prostate cancer. We selected men with a negative (PIRADS ≤2) or indeterminate (PIRADS 3) mpMRI. 4Kscore values were categorized into ranges of 1–7, 8–19, 20–32 and greater than 32. We evaluated the proportion of men with grade group 2 or higher (GG2+) cancer in groups defined by PIRADS and 4Kscore. We also evaluated the number of biopsies avoided and GG2+ cancer missed in each group reported depend on 4Kscore cutoff points.ResultsAmong 1111 men who had an mpMRI, 4Kscore and biopsy, 625 of them had PIRADS ≤3 on mpMRI: 374 negative (PIRADS ≤2) and 251 indeterminate (PIRADS 3). In men with a negative mpMRI, we found a 4Kscore cut‐point of 33 resulted in an increased risk of GG2+ cancer on biopsy. In patients with an equivocal lesion on mpMRI, men with a 4Kscore cutoff ≥8 had a greater risk of GG2+ cancer on biopsy. Decision curve analysis supported the proposed cut‐points in each mpMRI group.ConclusionsIn men with negative and indeterminate mpMRI, we found the best 4Kscore threshold to determine the need for biopsy to be 33 and 8 respectively. Future prospective studies in independent populations are needed to confirm these findings.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging

Thomas

Mason

et al. 2023

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“…Кроме этого, тестирование MPS предотвратило бы 387 (33 %) ненужных биопсий. В более позднем исследовании этих же авторов продемонстрировано, что значение MPS коррелирует с показателем PI-RADS (p <0,001), при этом пороговое значение MPS ≤25 предотвратило бы 39 % биопсий в популяции PI-RADS 3 [61].…”

Section: Myprostatescoreunclassified

Current understanding of prostate cancer biomarkers

Popov,

Guseynov,

Vasin

et al. 2024

Onkourologiâ

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Worldwide, prostate cancer has remained one of the most common malignant neoplasms among men and it is accompanied by high mortality rates. Standard methods for diagnosing prostate cancer have limited sensitivity and specificity, unnecessary biopsies are often performed, and the risk of overdiagnosis of the disease and overtreatment of patients is high. The review considers diagnostic and prognostic biological markers of prostate cancer proposed in recent years. Theoretical foundations for the use of new biomarkers are analyzed. The characteristics and practical significance of biomarkers of various groups (immunohistochemical, molecular and genetic, prostate specific antigen-associated, volatile organic metabolites) are presented. The need for further large-scale scientific research in the field of biomarker application in prostate cancer, criteria for their selection and evaluation are described. The introduction of modern diagnostic and prognostic markers into real clinical practice opens up new opportunities for improvement of prostate cancer diagnosis, individual prognosis, and rationalization of treatment strategy.

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“…A MPS threshold of ⩽ 25 would prevent 39% of biopsies in the PI-RADS 3 population while missing 6% of GG ⩾ 2 PCa. 48 MPS has also been evaluated in men with a prior negative biopsy. Using a slightly higher threshold of MPS ⩽ 15 to rule out biopsy would avoid 21% of biopsies with a 100% NPV.…”

Section: Biomarkers For Consideration Of Initial Biopsymentioning

confidence: 99%

Biomarkers for prostate cancer detection and risk stratification

Farha

Salami

2022

Therapeutic Advances in Urology

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Although prostate cancer (PCa) is the most commonly diagnosed cancer in men, most patients do not die from the disease. Prostate specific antigen (PSA), the most widely used oncologic biomarker, has revolutionized screening and early detection, resulting in reduced proportion of patients presenting with advanced disease. However, given the inherent limitations of PSA, additional diagnostic and prognostic tools are needed to facilitate early detection and accurate risk stratification of disease. Serum, urine, and tissue-based biomarkers are increasingly being incorporated into the clinical care paradigm, but there is still a limited understanding of how to use them most effectively. In the current article, we review test characteristics and clinical performance data for both serum [4 K score, prostate health index (phi)] and urine [SelectMDx, ExoDx Prostate Intelliscore, MyProstateScore (MPS), and PCa antigen 3 (PCA3)] biomarkers to aid decisions regarding initial or repeat biopsies as well as tissue-based biomarkers (Confirm MDx, Decipher, Oncotype Dx, and Polaris) aimed at risk stratifying patients and identifying those patients most likely to benefit from treatment versus surveillance or monotherapy versus multi-modal therapy.

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Urinary MyProstateScore (MPS) to Rule out Clinically-Significant Cancer in Men with Equivocal (PI-RADS 3) Multiparametric MRI: Addressing an Unmet Clinical Need

Cited by 16 publications

References 38 publications

Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging

Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging

Current understanding of prostate cancer biomarkers

Biomarkers for prostate cancer detection and risk stratification

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