PCA3 does not predict short-term biopsy progression
MedWire News: Short-term biopsy progression in men under active surveillance cannot be predicted by the level of PCA3 in their urine samples, research suggests.
Jeffrey Tosoian (Johns Hopkins Medical Institutions, Baltimore, Maryland, USA) and colleagues analyzed data from 294 men who were enrolled in an active surveillance program and provided a urine sample for analysis of the prostate-specific noncoding RNA, PC3A.
The enrolment criteria for this program are clinical stage T1c disease, prostate-specific antigen (PSA) density less than 0.15 ng/ml/cm3, Gleason score 6 or less, two or fewer biopsy cores with cancer and a maximum of 50% involvement of any core with cancer.
The majority of participants were White (91.8%), while 5.4% were Black and 2.8% had other ethnic backgrounds. Of the 294 study participants, 38 (12.9%) had progression to unfavorable biopsy features. Patients with and without progression were similar in terms of age, date of diagnosis, and time from diagnosis to PCA3 measurement.
Mean initial PCA3 score did not significantly differ between men with and without progression (60.0 vs 50.8).
Of the 38 patients with progression on biopsy, 16 (42.1%) had an unfavorable biopsy based on a Gleason score of 7 or greater. Among these 16 men, mean first PCA3 score did not significantly differ from that of the 22 patients who had progression by other criteria (72.0 vs 51.2), or from those without progression. .
Further analysis confirmed that PCA3 was not significantly associated with progression after adjusting for age and date of prostate cancer diagnosis.
Tosoian et al comment in the Journal of Urology: “Although active surveillance is among the potential management options for low-risk prostate cancer, optimal selection criteria and follow-up protocols during surveillance are currently being debated.”
They add: “Further analysis with additional follow-up is necessary to assess the usefulness of PCA3 combined with other biomarkers or in selected subsets of patients.”
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By James Taylor