MPS2-AS Urine Test: Reducing Biopsies in Prostate Cancer Surveillance

A new urine test, MPS2-AS, shows promise for detecting aggressive prostate cancers in men on active surveillance, potentially reducing the need for repeated biopsies. The test is based on the FDA-approved MyProstateScore 2.0 (MPS2) assay and can identify tumors at Grade Group 3 (Gleason 4+3) or higher, the threshold at which treatment is generally recommended.

In a study of 223 men undergoing surveillance biopsies, the MPS2-AS test correctly detected 93% of higher-grade tumors while potentially avoiding up to 67% of unnecessary biopsies. Patients first underwent MRI scans and standard or targeted biopsies, allowing researchers to compare MPS2-AS performance with existing tools. The test outperformed MRI alone, which would have avoided 48% of unnecessary biopsies while detecting 79% of aggressive tumors, and risk calculators, which had higher detection but less biopsy reduction.

The test supports in-office or at-home urine collection, providing a noninvasive method to identify men who truly need biopsy and those who can safely defer it. Experts emphasize that while results are encouraging, longer-term and larger-scale studies are needed to confirm the test’s effectiveness. If validated, MPS2-AS could transform active surveillance, improving patient safety and quality of life by minimizing invasive procedures without compromising cancer detection.

Wolinsky, H. (2025, December 8). Will this urine test be a biopsy killer for PC? Medscape. https://www.medscape.com/viewarticle/will-this-urine-test-be-biopsy-killer-pc-2025a1000y9g