Study Defines PCa Metastasis Predictors by ProQuest

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      36 Renal & Urology News                 JUNE 2009                                                                                       www.renalandurologynews.com


       s   2009 Genitourinary Cancers Symposium, Orlando




       Urine Test May Predict Aggressive PCa
      Investigational assay detects the fusion of two genes that occurs in about half of prostate cancers
                                                   other clinical information, to help dis-                                                explanation at the molecular level for
        The articles on this page report
                                                   tinguish which men can be moni-                                                         the dependence of prostate tumors
        on studies presented at the
        Genitourinary Cancers Symposium            tored and which require more aggres-                                                    on certain hormones, such as testos-
        held in Orlando.                           sive treatment, an invaluable tool                                                      terone, the T2:ERG urine test may be
                                                   for physicians.”                                                                        useful for determining which men
                                                     Widespread use of PSA testing has                                                     would respond best to ADT.
      BY JOHN SCHIESZER                            resulted in high rates of early                                                           “We have some very promising ini-
      A URINE TEST may enable clini-               prostate cancer detection, although                                                     tial data, but we are continuing clin-
      cians to predict which men diag-             many early-stage prostate tumors are                                                    ical research studies to define the
      nosed with prostate cancer are more          unlikely to become life-threatening,                                                    optimal clinical utility and assay for-
      likely to have aggressive disease and        Dr. Groskopf said. The PSA test is                                                      mat,” Dr. Groskopf told Renal &
      which men might benefit most from            not useful for distinguishing between                                                   Urology News. “We believe this gene
      androgen deprivation therapy (ADT).          men who need aggressive treatment                                                       fusion urine test is going to help with
        A prototype molecular assay called         and those who can be placed on                                                          probably the greatest unmet need in
      the T2:ERG urine test, which detects         active surveillance. The low specifici-                                                 prostate cancer diagnostics: discrimi-
      the fusion of two genes (TMPRSS2             ty of the PSA test can result in high       Jack Groskopf, PhD                          nating so-called significant from in-
      and ERG), was developed by re-               false-positive rates and unnecessary                                                    dolent cancers.”
      searchers at Gen-Probe Incorporated,         biopsies, he noted.                           TMPRSS2-ERG fusions were de-                Eric A. Klein, MD, Chairman of the
      San Diego. This fusion is found in             He and his colleagues prospective-        tected in 42% of the men with               Glickman Urological & Kidney Insti-
      about half of all prostate cancers and       ly analyzed TMPRSS2-ERG fusion              prostate cancer, a number that indi-        tute and Professor of Surgery at
      has been associated with more aggres-        mRNA levels in urine specimens from         cates high sensitivity because previous     Cleveland Clinic in Ohio, said this is
      sive disease.                                556 men scheduled for prostate biop-        studies have found that about 50% of        work that could significantly help im-
        “The T2:ERG urine test showed              sy. Those results were then correlated      men with prostate cancer have the           prove the management of prostate can-
      high specificity for detection of pros-      with biopsy outcome. All patients           gene fusion. Moreover, the T2:ERG           cer over the next two to three years.
      tate cancer at biopsy,” said lead author     were treated at three hospitals in          urine test correlated with criteria cur-    “This will add to our ability to deter-
      Jack Groskopf, PhD, Director of              California, Michigan, and Quebec.           rently used to identify aggressive can-     mine whether or not a person with a
      Research and Development at Gen-             The biopsies showed that 226 of the         cer at the time of biopsy: Gleason          specific PSA level actually has cancer,”
      Probe’s Cancer Diagnostics Division.         men (41%) had prostate cancer. 
								
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