PCA3 Materials & News

Ankerst DP, Groskopf J, Day JR, Blase A, Rittenhouse H, Pollock BH, Tangen C, Parekh D, Leach RJ, Thompson I. J Urol 2008;180:1303-8

•  This publication describes the incorporation of the Prostate CAncer gene 3 (PCA3) Score into the Prostate Cancer Prevention Trial (PCPT) risk calculator and shows that this improves the diagnostic accuracy of the calculator.
• The PCPT risk calculator combines prostate specific antigen (PSA), digital rectal examination (DRE), family history, biopsy history, age and race to determine the risk of prostate cancer (PCa) for individual men. More information: Nomograms
• A method was developed to incorporate the PCA3 Score into this calculator and the diagnostic accuracy of the new calculator was assessed.
• The Area Under the Curve (AUC) of the Receiver Operating Characteristics (ROC) of the PCPT risk calculator incorporating PCA3 was statistically significantly higher than that of the original PCPT risk calculator and PSA but not different from that of PCA3 (Table).
• At a specificity of 70%, the sensitivity of the PCPT risk calculator incorporating PCA3 was higher than that of the original PCPT risk calculator, PCA3 and PSA (Table).
• It can be concluded that the incorporation of PCA3 into the PCPT risk calculator statistically significantly improves its diagnostic accuracy. This refines the risk estimate of PCa for individual men when managed in daily clinical practice.
• In an editorial comment to this article Dr. de la Taille commented that today the use of the PCA3 Assay should be considered a revolution for at least 3 major reasons:

1. For the first time, mRNA testing is now routinely available for daily practice which opens new possibilities for using biomarkers in urine or serum;
2. The PCA3 Score correlates with PCa risk on repeat biopsy which can help urologists to better decide whether to repeat biopsies¹;
3. The PCA3 Score may be correlated to PCa aggressiveness and its use in selecting patients for active surveillance is under consideration². 

1) de la Taille A. Expert Rev Mol Diagn 2007;7:491-7
2) Nakanishi H, et al. J Urol 2008 ;179:1804-9

More information: Article at PubMed