Urine Test May Detect Aggressive Prostate Cancer and Reduce Biopsies: Study

The 18-gene MyProstateScore 2.0 (MPS2) test was previously validated for detection of grade group ≥ 2 (GG ≥ 2) prostate cancer using post–digital rectal examination (DRE) urine. To improve ease of testing, we validated MPS2 using first-catch, non-DRE urine. Patients provided first-catch urine before biopsy. MPS2 values were calculated using previously validated models differing only by extent of clinical data included biomarkers alone (BA; no clinical data), biomarkers and clinical factors (BA + CF), and biomarkers, clinical factors, and prostate volume (BA + CF + PV).

The primary outcome was GG ≥ 2 cancer on biopsy. MPS2 performance and clinical consequences of testing were compared with PSA and the Prostate Cancer Prevention Trial risk calculator (PCPTrc). -

Results: The cohort included 266 men with median PSA 6.6 ng/mL (IQR, 4.9-9.1) of whom 103 (39%) had GG ≥ 2 cancer on biopsy. The AUC for GG ≥ 2 cancer was 57% for PSA, 62% for PCPTrc, and 71%, 74%, and 77% for MPS2 models. Under a testing approach detecting > 90% of GG ≥ 2 cancers, MPS2 testing would have avoided 36% to 42% of unnecessary biopsies, as compared with 13% using the PCPTrc.

In patients with a prior negative biopsy, MPS2 testing would have avoided 44% to 53% of repeat biopsies, as compared with only 2.6% using PCPTrc. Using first-catch urine, MPS2 meaningfully improved the proportion of biopsies avoided relative to PCPTrc while maintaining highly sensitive detection of GG ≥ 2 cancer. Non-DRE testing provides a convenient, objective, and highly accurate testing option to reduce the need for imaging and biopsy in men with elevated PSA.

Reference:

Tosoian JJ, Zhang Y, Meyers JI, Heaton S, Siddiqui J, Xiao L, et al. Clinical Validation of MyProstateScore 2.0 Testing Using First-Catch, Non–Digital Rectal Examination Urine. Journal of Urology [Internet]. [cited 2025 Mar 13];0(0). Available from: https://www.auajournals.org/doi/abs/10.1097/JU.0000000000004421