A breakthrough in prostate cancer testing: introducing MPS2

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Researchers at the University of Michigan Health Rogel Cancer Center have made a significant advancement in prostate cancer diagnosis by developing a new urine-based test called MyProstateScore2.0 (MPS2).

This innovative test is designed to differentiate between slow-growing prostate cancers, which are less likely to cause harm, and more aggressive forms that require immediate treatment.

Prostate cancer can vary significantly in its progression. While some forms grow slowly and may never pose a serious threat to health, others can be aggressive and life-threatening.

Historically, distinguishing between these types has been challenging, leading to unnecessary treatments for some while delaying crucial interventions for others.

The MPS2 test examines 18 specific genes associated with high-grade prostate cancers.

By analyzing these genetic markers in urine and tissue samples from men diagnosed with prostate cancer, the test has proven effective in identifying cancers that are Gleason 3+4=7 (Grade Group 2 or higher).

These are the types of cancers that are more likely to grow and spread compared to the less aggressive Gleason 6 or Grade Group 1 cancers.

The test builds on the foundation laid by a previous version, the original MyProstateScore (MPS), which was also developed by the same team at the University of Michigan nearly a decade ago.

The original test was based on the discovery of a gene fusion, TMPRSS2::ERG, known to be involved in prostate cancer, along with another marker called PCA3. While effective, there was still a need to improve the detection of clinically significant, high-grade cancers.

To enhance the test’s accuracy, researchers undertook extensive RNA sequencing of over 58,000 genes. This allowed them to narrow down to 54 candidate genes that were overexpressed in high-grade cancers.

After further analysis and validation using samples from the National Cancer Institute’s Early Detection Research Network, they refined the list to 18 key markers.

This collaborative effort involved more than 30 laboratories across the United States, ensuring a diverse and robust sampling.

The researchers tested the markers against urine samples collected between 2008 and 2020 from about 700 patients who were undergoing prostate biopsies due to elevated PSA levels, a common indicator of prostate issues.

The results of MPS2 testing have been impressive. Not only has the test demonstrated high accuracy in identifying more serious forms of prostate cancer, but it has also shown near-perfect accuracy in ruling out Grade Group 1 cancers.

This precision is crucial in helping patients avoid unnecessary biopsies, which can be invasive and stressful. With MPS2, up to 41% of these unnecessary procedures could be avoided, compared to just 11% with PSA testing alone.

This test is particularly beneficial for men who have previously undergone biopsies with negative results but continue to show elevated PSA levels.

MPS2 can identify half of these cases where a repeat biopsy would also likely be negative, thus sparing these patients from another invasive procedure.

MPS2 is now available through LynxDx, a spin-off company from the University of Michigan, which holds the exclusive license to commercialize this test. Patients seeking more information or considering this test can contact the Michigan Medicine Cancer AnswerLine.

This advancement in prostate cancer testing represents a significant step forward in the field of oncology, offering hope for more precise and personalized cancer care.

The research findings can be found in JAMA Oncology.

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