PCA3 Materials & News

Amberson JB, Blase A, Cochran JS, Groskopf J, Harper WM, Johnston WG, Kella N, Koziol I, Patsias G, Rabin M, Rittenhouse H, Williams TH, Weber A. J Urol 2009;181 (4 Suppl):812 (abs 2243)

• This abstract was presented as a poster at the 2009 annual meeting of the American Urological Association (AUA) in Chicago, USA
• This multi-centre US study showed that Prostate CAncer gene 3 (PCA3) had the highest diagnostic accuracy for predicting prostate biopsy outcome and that its combination with other clinical factors may further improve the diagnostic accuracy for predicting prostate cancer and identifying high-risk patients
• The study was performed in 463 men referred for initial (76%) or repeat (24%) >=12-core prostate biopsy because of elevated prostate specific antigen (PSA) level or suspicious digital rectal examination (DRE) at 7 community-based urologic clinics
• The informative rate of the PCA3 Assay was 99%
• The positive biopsy rate was 44%
• The PCA3 Assay had the highest area under the receiver operator curve (AUC ROC) for predicting prostate biopsy outcome (Table 1). The combination of PCA3 plus free PSA had a higher AUC ROC compared to PCA3 or free PSA alone
• Logistic regression analysis showed that PCA3 statistically significantly increased the diagnostic accuracy when added to a model predicting biopsy outcome incorporating age, family history, race and prior biopsy (Table 2)
• The combination of PCA3 and free PSA had a greater sensitivity than PCA3 or free PSA alone at all fixed specificity levels (Figure)
• It was concluded that in this multi-centre study of men enrolled at community-based urologic clinics the PCA3 Assay has a high informative rate. The performance of the PCA3 Assay was consistent with previously published data and significantly better than serum PSA. The PCA3 Score can be used as an independent and additive test to PSA in the detection of prostate cancer on biopsy. In addition, the PCA3 Score can significantly add to existing algorithms to improve diagnostic accuracy for predicting prostate biopsy outcome and identifying high-risk patients

AUC: area under the (receiver operating characteristic) curve;   CI: confidence interval

*: vs.model A; AUC: area under the (receiver operating characteristic) curve;   CI: confidence interval