Presentation Authors: Patrick Whelan*, CHICAGO, IL, Wei Phin Tan, Durham, NC, Jennifer Poirier, Chicago, IL, Leslie Deane, Miami, FL
Introduction: Prostate cancer (CaP) remains a disease with significant morbidity and mortality. To prevent a rise in CaP morbidity and mortality, prostate specific antigen (PSA) screening cannot be abandon, despite recent screening recommendations. However, a significant portion of men are over treated and over screened for indolent CaP. Although PSA screening saves lives, there remains a need to better identify men who will develop lethal CaP. Multiple biomarkers and multiparametric magnetic resonance imaging (mpMRI) have been developed that may aid in this advancement.
Methods: PSA, 4K score, (Michigan Prostate Score) MiPS and mpMRI were retrospectively reviewed from a prospectively collected and maintained database according to the clinical pathway shown in Figure 1. Data was analyzed for the ability of each biomarker to predict prostate cancer, GS 3+4 prostate cancer and PI-RADS 3 or greater lesion on mpMRI in 36 patients. Overall and grade group (GG) 2+ CaP detection rates were determined. Patients were grouped into CaP positive, negative and MRI negative groups. All groups were compared using nested linear models. Post-hoc analysis was then performed to compare individual groups.
Results: 65% and 58% of men were diagnosed with CaP and GG2+ CaP, respectively. Cohort data and biopsy data are shown in Table 1 and 2. Patients with CaP were more likely to have higher MiPS high-grade CaP %, higher MiPS CaP % and PSAD (p < 0.05) compared to those without prostate cancer. Notably, there was no difference in 4K score, MiPS overall and high-grade cancer % between those without cancer and those with a negative mpMRI.
Conclusions: The use of 4K score, MiPS score and mpMRI compared to traditional PSA screening alone provided a greater clinically significant prostate cancer detection rate compared to traditional positive biopsy rates.