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GU symposium.qxp 6/1/09 11:32 AM Page 2 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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