Urine-based test detects aggressive prostate cancer

Traditional approaches to prostate cancer screening involve blood tests, MRI, and biopsies. However, in addition to being uncomfortable, some of these procedures result in overdiagnosis of low-grade cancers. In a new study, researchers at the University of Michigan Health Rogel Cancer Center have clinically validated a previously developed urine test, which can potentially bypass these invasive procedures among men who are unlikely to benefit.

Prostate cancers are categorized based on their Gleason Grade or Grade Group. Those with Gleason 3+4=7, or Grade Group 2, or higher are more likely to grow and cause harm in comparison with Gleason 6 or Grade Group 1 prostate cancers, which are considered non-aggressive. The urine test, called MyProstateScore 2.0, or MPS2, looks at 18 different genes linked to high-grade prostate cancer. 

The researchers had previously demonstrated that the test was effective in identifying GG2 or higher cancers, helping patients avoid unnecessary biopsies. However, in that study, urine samples were obtained after a digital rectal examination.

In the study, the team modified the urine collection approach so that the MPS2 test could detect markers for prostate cancer, without requiring a prior rectal exam. Using urine samples from a cohort of 266 men who did not undergo a rectal exam, they found that the test could detect 94% of GG2 or higher cancers and was more sensitive than blood tests. Further, the team used mathematical models to demonstrate that the use of MPS2 would have avoided up to 53% of unnecessary biopsies.

“These results show that MPS2 has promise as an at-home test,” Ganesh S. Palapattu from University of Michigan and a coauthor of the paper said in a release. “Its primary benefit is that the test can accurately predict your probability of developing aggressive prostate cancer, putting both the patient and physician at ease.” MPS2 can also help patients save on healthcare costs since it is significantly cheaper than an MRI. The researchers are hoping to study the test’s performance in men as a surveillance screen for low-risk prostate cancer.