Urine Tmprss2:Erg For Prostate Cancer Risk Stratification In Men With Elevated Serum Psa

Background: Over 1,000,000 men undergo prostate biopsy each year in the U.S., most for “elevated” serum PSA. Given the lack of sensitivity and specificity, and unclear mortality benefit of PSA testing, methods to individualize management of elevated PSA are needed. We evaluated urine expression of TMPRSS2:ERG, a gene fusion occurring in 50% of prostate cancers, for risk-stratifying men presenting for biopsy. Methods: TMPRSS2:ERG was measured by a clinical grade, transcription-mediated-amplification assay in prospectively collected whole-urine from 1,094 men undergoing biopsy at 10 academic and community clinics. Findings: Urine TMPRSS2:ERG was associated with indicators of clinically significant cancer at biopsy and prostatectomy, including tumor size, high prostatectomy Gleason score and upgrading at prostatectomy. TMPRSS2:ERG in combination with urine PCA3, improved the multivariate PCPT risk calculator performance for predicting cancer on biopsy (AUC in test set, 0.79 vs. 0.64, p Interpretation: Urine TMPRSS2:ERG, in combination with urine PCA3, enhances the utility of serum PSA for predicting prostate cancer and clinically relevant cancer on biopsy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2815. doi:10.1158/1538-7445.AM2011-2815