<i>PCA3</i>
            Score Before Radical Prostatectomy Predicts Extracapsular Extension and Tumor Volume

Whitman, Eric J.; Groskopf, Jack; Ali, Amina; Chen, Yongmei; Blase, Amy; Furusato, Bungo; Petrovics, György; Ibrahim, Mohamed T.; Elsamanoudi, Sally; Cullen, Jennifer; Sesterhenn, Isabell A.; Brassell, Stephen A.; Rittenhouse, Harry G.; Srivastava, Shiv; McLeod, David G.

doi:10.1016/j.juro.2008.07.060

Cited by 162 publications

(97 citation statements)

References 17 publications

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“…However some data do show a dependency between PCA3 score and extracapsular spread and tumor volume [15]. PCA3 is probably not useful either for monitoring success of therapy, as in our patients there was very low cellularity in urine.…”

Section: Discussionmentioning

confidence: 55%

Prognostic and predictive molecular biological markers in prostate cancer – significance of expression of genes PCA3 and TMPRSS2

Soumarová¹,

Bóday²,

Krhutova³

et al. 2015

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Prostate specific antigen and digital rectal examination have low specificity for detecting prostate cancer and they poorly predict the presence of aggressive disease. We present recent findings on PCA3 and TMPRSS:ERG fusion and assessed the relationship between PSA, urine PCA3 and TMPRSS2:ERG and corelation with pathological findings. We tested the PCA3 score in two groups. The first comprised 96 men treated in urology out-patient units with suspicion of prostate cancer, who had elevated PSA and/or positive DRE. The second group comprised 28 patients, who were treated by radiation for localised prostate cancer, and whose PCA3 was regularly monitored. A further cohort comprised patients with already-diagnosed tumors, who had undergone radical prostatectomy. With these, using histopathological samples, we examined samples of the TMPRSS2:ERG fusion gene and compared the results with Gleason score values and level of PSA. We also examined the TMPRSS2:ERG gene in patients who had positive biopsy. Part of the genetical analysis was also an examination of the MSMB gene.The sensitivity of PCA3 testing was 66.7% and the specificity 78.5%. TMPRSS2:ERG gene was correllated with the Gleason score. Neither the TMPRSS2:ERG (p=0.13) nor the MSMB (p=0.556) genotype had an influence on the value of the Gleason score. However a difference was found between the homozygote and wild type (WT) in the TMPRSS2 gene.FISH analysis of TMPRSS/ERG gene fusion was evaluated as positive in 8 (36.8%) of the biopsically verified tumors and in 20 (37.3%) of the evaluated patients after RAPE of parafin slicing.We did not confirm a corellation between fusion and Gleason score (p=0.29).PCA3, with its higher sensitivity in comparison with PSA, is more useful for eventual screening examination. Identification of further molecular markers such as TMPRSS2, may be very promising ways to determine further prognosis of patients with prostate cancer.

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Section: Discussionmentioning

confidence: 55%

Prognostic and predictive molecular biological markers in prostate cancer – significance of expression of genes PCA3 and TMPRSS2

Soumarová¹,

Bóday²,

Krhutova³

et al. 2015

neo

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“…Recently, a PCA3-based nomogram has been presented by Chun et al (16) that identifies men at risk of harboring PCa and it assists in deciding whether further evaluation is necessary. When PCA3 is combined with serum PSA and biopsy GS, it increased diagnostic accuracy to 90% to predict extracapsular extension or clinically low volume (< 0.5 cc) tumor (17). Patients with a biopsy GS of 6, low PSA and a low PCA3 could be excellent candidates for active surveillance.…”

Section: Discussionmentioning

confidence: 99%

The novel prostate cancer antigen 3 (PCA3) biomarker

et al. 2010

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PCA3 is a prostate specific, nonprotein coding RNA that is significantly over expressed in prostate cancer, without any correlation to prostatic volume and/or other prostatic diseases (e.g. prostatitis). It can now easily be measured in urine with a novel transcription-mediated amplification based test. Quantification of PCA3 mRNA levels can predict the outcome of prostatic biopsies with a higher specificity rate in comparison to PSA. Several studies have demonstrated that PCA3 can be used as a prognostic marker of prostate cancer, especially in conjunction with other predictive markers. Novel PCA3-based nomograms have already been introduced into clinical practice. PCA3 test may be of valuable help in several PSA quandary situations such as negative prostatic biopsies, concomitant prostatic diseases, and active surveillance. Results from relevant clinical studies, comparative with PSA, are warranted in order to confirm the perspective of PCA3 to substitute PSA.

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“…6 Recent reports described the use of PCA3 testing to identify patients with aggressive versus indolent prostate cancer. [9][10][11][12][13][14][15][16][17][18][19][20][21] Results of studies have been mixed. If the PCA3 test correlates with disease prognosis, it could be a valuable tool in identifying patients who are better treated with expectant management (e.g., aggressive follow-up of the tumor without radical treatment intervention) versus those better treated with curative therapy (e.g., surgery or radiation therapy).…”

Section: Background and Clinical Context For The Recommendationmentioning

confidence: 99%

“…[10][11][12][14][15][16][17][18]20,21 Three studies included data on biopsy results, 9,10,18 seven on prostatectomy results, 12,[14][15][16][17]20,21 and one on both. 11 Two studies were conducted on subjects in an active surveillance program.…”

Section: Clinical Utilitymentioning

confidence: 99%

Recommendations from the EGAPP Working Group: does PCA3 testing for the diagnosis and management of prostate cancer improve patient health outcomes?

Calonge

Klein

Berg

et al. 2014

Genetics in Medicine

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Summary of recommendations:The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group found insufficient evidence to recommend prostate cancer antigen 3 (PCA3) testing to inform decisions for when to rebiopsy previously biopsy-negative patients for prostate cancer or to inform decisions to conduct initial biopsies for prostate cancer in at-risk men (e.g., previous elevated prostate-specific antigen test or suspicious digital rectal examination).The EGAPP Working Group found insufficient evidence to recommend PCA3 testing in men with cancer-positive biopsies to determine if the disease is indolent or aggressive in order to develop an optimal treatment plan.Based on the available evidence, the overall certainty of clinical validity to predict the diagnosis of prostate cancer using PCA3 is deemed "low. " The EGAPP Working Group discourages clinical use for diagnosis unless further evidence supports improved clinical validity.Based on the available evidence, the overall certainty of net health benefit is deemed "low. " The EGAPP Working Group discourages clinical use unless further evidence supports improved clinical outcomes.Rationale: It has been suggested that PCA3 testing in the general male population might lead to earlier diagnosis and management changes (e.g., earlier detection and earlier initiation or higher rates of medical interventions) that improve outcomes. EGAPP Working Group found no direct evidence to support this possibility, so we sought indirect evidence aimed at documenting the extent to which PCA3 testing alters prostate cancer diagnosis or management, alone and in combination with traditional clinical management factors, and the extent to which this testing improves health outcomes.Analytic validity: Assay-related evidence was deemed adequate for the PROGENSA PCA3 assay approved by the US Food and Drug Administration, available from Gen-Probe. Very few studies were available that investigated preanalytical effects, analytical performance, and diagnostic accuracy of other quantitative assays for PCA3.Clinical validity: Evidence on clinical validity was rated inadequate to derive any conclusions about performance of PCA3 testing to inform decisions for when to rebiopsy previously biopsy-negative patients for prostate cancer, or to inform decisions to conduct initial biopsies for prostate cancer in at-risk men (e.g., previous elevated prostate-specific antigen test or suspicious digital rectal examination). Furthermore, there was little evidence to derive any conclusions about performance of PCA3 testing in men with cancer-positive biopsies to determine if the disease is indolent or aggressive in order to develop an optimal treatment plan. Clinical utility:No studies were available to provide direct evidence on the balance of benefits and harms related to PCA3 testing for diagnosis and management in the general male population. Evidence for other populations (e.g., high risk) was not evaluated in the review.

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PCA3 Score Before Radical Prostatectomy Predicts Extracapsular Extension and Tumor Volume

Abstract: PCA3 detected in the post-digital rectal examination urine of patients with prostate cancer correlated with pathological findings. Therefore, it could provide prognostic information. To our knowledge this is the first report of a molecular urine assay that predicts extracapsular extension.

Cited by 162 publications

References 17 publications

Prognostic and predictive molecular biological markers in prostate cancer – significance of expression of genes PCA3 and TMPRSS2

Prognostic and predictive molecular biological markers in prostate cancer – significance of expression of genes PCA3 and TMPRSS2

The novel prostate cancer antigen 3 (PCA3) biomarker

Recommendations from the EGAPP Working Group: does PCA3 testing for the diagnosis and management of prostate cancer improve patient health outcomes?

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