Racial Variation in the Utility of Urinary Biomarkers PCA3 and T2ERG in a Large Multicenter Study

• Type of Material: Article
• Authors: Padraic G O'Malley, Weill Cornell Medical College; Daniel P. Nguyen, Universität Bern; Bashir Al Hussein Al Awamlh, Weill Cornell Medical College; Guojiao Wu, Weill Cornell Medical College; Ian M Thompson, University of Texas; Martin Sanda, Emory University; Mark Rubin, Weill Cornell Medical College; John T Wei, University of Michigan; Richard Lee, Weill Cornell Medical College; Paul Christos, Weill Cornell Medical College; Chris Barbieri, Weill Cornell Medical College; Douglas S Scherr, Weill Cornell Medical College
• Language: English
• Date: 2017-07-01
• Publisher: Elsevier: Journal of Urology
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Urological Association Education and Research, Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.juro.2017.01.058
• Title of Journal or Parent Work: Journal of Urology, The
• ISSN: 0022-5347
• Volume: 198
• Issue: 1
• Start Page: 42
• End Page: 48
• Grant/Funding Information: Dr. Paul Christos and Ms. Guojiao Wu, MS, were partially supported by the following grant: Clinical and Translational Science Center at Weill Cornell Medical College (UL1-TR000457-06).; Dr. P O’Malley supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust and by the Ferdinand C. Valentine Fellowship Award from the New York Academy of Medicine.; Supported by NIH grant 5U01CA113913-07 as part of the Early Detection Research Network.
• Keywords: PSA; human; prostatic neoplasms; MEN; VALIDATION; African Americans; ACTIVE SURVEILLANCE; ASSOCIATION; PREVENTION TRIAL; DISEASE; PERFORMANCE; PROSTATE-CANCER RISK; tumor; CALCULATOR; gene fusion; biomarkers; prostate cancer antigen 3; Urology & Nephrology; Science & Technology; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Pathology

Abstract

Purpose To our knowledge it is unknown whether urinary biomarkers for prostate cancer have added utility to clinical risk calculators in different racial groups. We examined the utility of urinary biomarkers added to clinical risk calculators for predicting prostate cancer in African American and nonAfrican American men. Materials and Methods Demographics, PCPT (Prostate Cancer Prevention Trial) risk scores, data on the biomarkers data PCA3 (prostate cancer antigen 3) and T2ERG (transmembrane protease serine 2 and v-ets erythroblastosis virus E26 oncogene homolog gene fusion), and biopsy pathology features were prospectively collected on 718 men as part of EDRN (Early Detection Research Network). Utility was determined by generating ROC curves and comparing AUC values for the baseline multivariable PCPT model and for models containing biomarker scores. Results PCA3 and T2ERG added utility for the prediction of prostate cancer and clinically significant prostate cancer when combined with the PCPT Risk Calculator. This utility was seen in nonAfrican American men only for PCA3 (AUC 0.64 increased to 0.75 for prostate cancer and to 0.69–0.77 for clinically significant prostate cancer, both p <0.001) and for T2ERG (AUC 0.64–0.74 for prostate cancer, p <0.001, and 0.69–0.73 for clinically significant prostate cancer, p = 0.029). African American men did not have an added benefit with the addition of biomarkers, including PCA3 (AUC 0.75–0.77, p = 0.64, and 0.65–0.66, p = 0.74) and T2ERG (AUC 0.75–0.74, p = 0.74, and 0.65–0.64, p = 0.88), for prostate cancer and clinically significant prostate cancer, respectively. Limitations include the small number of African American men (72). The post hoc subgroup analysis nature of the study limited findings to being hypothesis generating. Conclusions As novel biomarkers are discovered, clinical utility should be established across demographically diverse cohorts.