MyProstate Score 2.0: A Promising Urine-Based Diagnostic Tool for High-Grade Prostate Cancer Detection

A newly developed urine test, MyProstate Score 2.0 (MPS2), shows promise in improving the detection of high-grade prostate cancer (PC) while reducing unnecessary biopsies. Traditional prostate-specific antigen (PSA) testing lacks specificity, often leading to overdiagnosis and invasive procedures for indolent cancers. MPS2, created using a qPCR technique that targets 18 genes—9 of which are specific to aggressive cancer—demonstrated strong predictive performance in a development cohort of 815 men and an external validation group of 813 participants. In both groups, MPS2 effectively identified high-grade PC, outperforming current tools like PSA, PHI, and existing gene models. For instance, MPS2 achieved a sensitivity of 95% and negative predictive values between 95–99% for grade 2 or higher cancers, with a potential to reduce unnecessary biopsies by up to 42%. Particularly useful in patients with prior negative biopsies, MPS2 showed higher specificity than alternatives. However, limitations include low ethnic diversity and the use of systematic biopsy as a reference standard. Despite these, MPS2 offers a more accurate and less invasive diagnostic approach for high-grade prostate cancer and may become an important tool in improving prostate cancer screening practices.

Tosoian JJ, Zhang Y, Xiao L, et al; EDRN-PCA3 Study Group. Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer. JAMA Oncol. 2024 Apr 18. doi: 10.1001/jamaoncol.2024.0455.