Beating the Biopsy

Prostate cancer diagnostics have undergone a rollercoaster of opinion over the years. Is the prostate-specific antigen (PSA) test reliable or not? Are patients receiving biopsies that may not be necessary? Are patients being over-treated as a result of false-positive test results?

A new study from Queen Mary University of London aims to reduce false positives and, by doing so, prevent biopsies and treatments that are not only expensive, time-consuming, and painful – but also, in some cases, entirely unnecessary. Instead of proceeding directly from a positive PSA test to prostate biopsy, Yong-Jie Lu and his team measured the levels of circulating tumor cells (CTCs) in patients’ blood – a more reliable detector of cancer than the PSA protein, but without the downsides of an invasive procedure. The result? By combining both blood tests, the researchers improved their ability to predict clinically significant prostate cancer – and adding a prognostic 12-gene panel further amplified that improvement (1). There’s still some way to go before the test becomes widely available; it needs further validation and regulatory approval.

“The current prostate cancer test often leads to […] significant harm to patients and a waste of valuable healthcare resources. There is clearly a need for better selection of patients to undergo the biopsy procedure,” Lu said in a recent press release (2). “By combining the new CTC analysis with the current PSA test, we were able to detect prostate cancer with the highest level of accuracy ever seen in any biomarker test, which could spare many patients unnecessary biopsies.”