Progensa^TM PCA3 test for prostate cancer detection

De la Taille A. Expert Rev Mol Diagn 2007;7:491-7

• This review discusses the role of Prostate CAncer gene 3 (PCA) in prostate cancer (PCa) detection.
• Approximately 60% of men with an elevated serum prostate specific antigen (PSA) level or suspicious digital rectal examination (DRE) have a negative prostate biopsy outcome.
• 20-40% of men with an initial negative prostate biopsy have PCa upon repeat biopsy.
• Prostate biopsy is invasive and can be unpleasant and associated with anxiety and complications such as haematuria, rectal bleeding and haematospermia.
• Therefore, there is need for additional biomarkers that can identify patients at high risk of PCa and thereby reduce the number of unnecessary biopsies.
• PCA3 is specifically over-expressed (66-fold) in PCa cells.
• The PROGENSA^TM PCA3 Assay developed by Gen-Probe is CE-marked and commercially available in Europe.
• It measures post-DRE (3 strokes per lobe) PCA3 messenger RNA (mRNA) from male urine.
• This test provides informative rates (ability for accurately measuring mRNA and calculating the PCA3 Score) of at least 94%.
• The higher the PCA3 Score, the higher the likelihood of a positive biopsy (Figure).
• The performance of the PCA3 Assay is similar for men undergoing a first biopsy or repeat biopsy and, in contrast to serum PSA, independent of prostate volume.
• The PCA3 Score increases linearly with tumour volume and is higher in men with significant than in men with low tumour volume/low grade PCa.
• Serum PSA remains a mainstay of PCa detection but is value should be enhanced via combination with emerging markers such as PCA3.

Reviewed by

Prof. B. Tombal

More information: http://www.ncbi.nlm.nih.gov/pubmed/