Validation of the MyProstateScore test to rule out clinically significant cancer

The MyProstateScore (MPS) test had been validated previously for improved detection of clinically significant (Gleason grade group [GG] ≥2 [i.e., a Gleason score of 7 or more]) prostate cancer relative to PSA-based risk calculators.  The authors sought to validate an optimal MPS threshold for use in ruling out GG ≥2 cancer in men referred for biopsy.

Men who had never undergone a prostate biopsy underwent a digital rectal examination and then provided a urine sample before they were biopsied. The MPS was calculated using their validated model including serum PSA, urinary PCA3, and urinary TMPRSS2: ERG gene protein. The MPS threshold of 10 provided 97% sensitivity and 98% negative predictive value for GG ≥2 cancer and would have prevented 33% of unnecessary biopsies while missing only 3% of GG ≥2 cancers. This testing approach would reduce the use of biopsy procedures after screening with PSA.  A drawback of this test is that it requires a finger rectal examination massaging the prostate before collecting the urine sample rather than a simple blood test.

J Urol, 2021; 205:732-739.