New Urine Test for Prostate Cancer Detection

A recent study has led to the development of a novel urine-based test aimed at identifying prostate cancers.

This innovative method could significantly minimize the reliance on invasive and often uncomfortable biopsies.

By examining urine samples from prostate cancer patients both before and after prostate-removal surgeries, and comparing them with samples from healthy individuals, researchers pinpointed three biomarkers—TTC3, H4C5, and EPCAM—that effectively indicate the presence of prostate cancer.

These biomarkers were found in patients prior to surgery but were nearly undetectable afterward, confirming their origin in prostate tissue.

The findings were published in eBioMedicine.

Prostate cancer stands as a major cause of male mortality in the U.S., typically diagnosed through blood tests measuring PSA, a protein associated with both cancerous and noncancerous prostate tissues. Generally, a PSA level above 4.0 nanograms per milliliter is viewed as abnormal, often resulting in a recommendation for a biopsy, where multiple tissue samples are extracted using small needles.

Nevertheless, the PSA test’s lack of specificity frequently necessitates biopsies to confirm a cancer diagnosis. Ranjan Perera, senior study author and director of the Center for RNA Biology at Johns Hopkins All Children’s Hospital, pointed out that many of these biopsies return negative results and can lead to unforeseen complications. Moreover, PSA tests can sometimes prompt unnecessary treatment for low-grade prostate cancers that are unlikely to progress within a short time frame.

Perera remarked, “This new biomarker panel offers a promising, sensitive, and specific, noninvasive diagnostic test for prostate cancer.”

The panel was able to detect prostate cancer even when PSA levels were normal, distinguishing it from prostatitis and benign prostatic hyperplasia (BPH).

As Christian Pavlovich, coauthor of the study, noted, “There is a real need for non-PSA-based biomarkers for prostate cancer, and urine is quite easy to collect in the clinic.” Many urologists agree that a reliable urinary biomarker would greatly enhance current diagnostic methods.

Throughout the study, researchers analyzed urine samples from both healthy individuals and patients with confirmed prostate cancer undergoing surgeries at various institutions.

They examined a total of 341 urine specimens (107 from healthy individuals, 136 from patients with prostate cancer before surgery, and 98 after surgery) during the development phase, followed by another 1,055 specimens for validation.

In the evaluation phase, samples from patients with BPH or prostatitis were also analyzed. Researchers extracted RNA from prostate cells found in urine and conducted comprehensive analyses to study gene expression.

Initially identifying 815 prostate-specific genes from urine samples, the team narrowed it down to 50, and then selected the top three biomarkers for further examination.

Significantly, the expression levels of these three biomarkers were higher in urine samples from individuals with prostate cancer compared to healthy controls, diminishing to low levels after surgery. More patients tested positive for these biomarkers than for PCA3, another prostate cancer-associated biomarker.

Study coauthor Vipul Patel emphasized, “This test has the potential to help physicians improve diagnostic accuracy of prostate cancer, reducing unnecessary interventions while allowing early treatment for those who need it.”

Looking ahead, researchers are exploring how this biomarker panel might be utilized alongside a PSA test to create a “super PSA.” Perera indicated that the next steps involve conducting independent trials and further developing the test for laboratory applications in clinical settings. They have also filed a patent and are in the process of establishing a company with support from Johns Hopkins.

Additional coauthors hail from various institutions, including Johns Hopkins and Charles University in Prague.

Funding for this research was provided by several organizations, including the International Prostate Cancer Foundation and the Johns Hopkins Kimmel Cancer Center.

In related news, Bettegowda collaborates with organizations like Haystack Oncology and is a cofounder of diagnostics companies.