Prostate Cancer Coverage from Every Angle

Early Detection of Aggressive Prostate Cancer: Urine-Based Multibiomarker Test Under Study

By: Emily Rhode
Posted: Wednesday, May 26, 2021

Simpa S. Salami, MD, MPH, of the University Michigan Medical School, Ann Arbor, and colleagues have developed a novel next-generation sequencing multibiomarker urine assay that may prove to be a useful supplement to prostate-specific antigen (PSA) testing for early detection of aggressive prostate cancer. This research, which was published in European Urology Oncology, suggested the noninvasive urine-based biopsy method, known as UPSeq, may help to overcome prostate cancer heterogeneity and multifocality. The researchers plan to continue to develop and validate the test in additional patients.

“The problem is that a patient can have multiple areas of cancer in the prostate, and these areas may be different than each other,” commented Dr. Salami in a Michigan Medicine press release. “Because of this, both prostate biopsies and MRI scans can miss evidence of aggressive disease. So, this urine test is designed to tell us what’s really happening throughout the whole prostate.”

Following a digital prostate exam, urine samples from 126 patients with benign to grade group (GG) 5 prostate cancer were collected. RNA isolation and custom targeted RNA next-generation sequencing were performed on the samples. The team then used machine learning to develop a 15-transcript model. The model was validated and outperformed both serum PSA and the Michigan Prostate Score in predicting GG ≥ 3 in the held-out validation set, according to the investigators.

However, the authors acknowledged several limitations to their study. First, postdigital rectal exam whole urine is superior to urinary sediments or exosomes. Second, there may have been a bias in the way the cohorts were chosen. Third, patients with benign biopsy may have undetected prostate cancer foci.

Disclosure: For full disclosures of the study authors, visit

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