A new urine test for prostate cancer that measures minute fragments of ribonucleic acid (RNA) is now commercially available nationwide through the University of Michigan MLabs. The new test [Mi-Prostate Score (MiPS)], improves the utility of the PSA blood test, increases physicians’ ability to differentiate high-risk prostate tumors from low-risk tumors in patients, and may help many men avoid unnecessary biopsies. While there are currently no perfect biomarkers that identify only high-risk prostate cancer, the MiPS test incorporates blood PSA levels and two molecular RNA biomarkers specific for prostate cancer in one final score that provides men and their doctors with a more personalized prostate cancer risk assessment. One biomarker is a snippet of RNA made from a gene (PCA3) that is overactive in 95 percent of all prostate cancers. The second biomarker is RNA that is made only when two genes (TMPRSS2 and ERG) abnormally fuse. The presence of this fusion RNA in a man’s urine is very specific for prostate cancer. A commercial urine test (PROGENSA PCA3) for PCA3, developed and marketed by the California-based biotech company Gen-Probe, gained FDA approval in 2012 for use in men who are considering repeat biopsy after an initially negative result. The new urine test offered by MLabs that measures both PCA3 and TMPRSS2:ERG should improve a doctor’s ability to stratify men suspected of having prostate cancer. In a study published in Science Translational Medicine, University of Michigan investigators found a correlation between the highest rates of cancer in men with the highest levels of TMPRSS2:ERG and PCA3 in their urine. The men in the study were divided into three groups based upon the levels of TMPRSS2:ERG and PCA3 in their urine: low, intermediate and high levels. Cancer was diagnosed in each of the groups respectively: 21%, 43%, and 69%. High-grade prostate cancer, defined in the study as a Gleason score greater than 6, also occurred at different frequencies in the three groups with 7%, 20%, and 40% diagnosed in each group respectively. For additional information on this test, see the following link from the December 20th, 2013 Prostate Cancer Foundation Newsletter. Earlier references to these tests can also be found on this website in 2013 posts dated October 8th, and July 16th as well as those dated March 25th, 2012 and September 21st, 2011.
First and foremost, as we are nearing the end of 2013, I wish to thank the nearly 200,000 readers of this website. Writing it is a joy for me personally, and it was especially gratifying to receive comments from prostate cancer patients who had been successfully treated at my “alma mater”, Johns Hopkins in Baltimore, Maryland. Hopkins continues to be one of the best sources of information about this disease as evidenced by recent articles on brachytherapy and general therapy options in the Johns Hopkins Health Alerts to which one can subscribe. There is a lot of new medical information which will be posted shortly. At this time however, I would like to wish you all a belated meaningful and gratifying Christmas season and a truly fulfilling and healthy New Year. The significance of these holidays is best expressed by the prophets Isaiah and Jeremiah as follows. “For a child (Jesus) will be born to us, a Son will be given to us, and the government will rest on His shoulders; and His name will be called Wonderful Counselor, Mighty God, Eternal Father, Prince of Peace.” (Isaiah 9:6). “‘For I know the plans I have for you’, declares the Lord, ‘plans for welfare’ (not governmental) ‘and not calamity to give you a future and a hope.'” (Jeremiah 29:11.) Finally, a verse from Matthew 1:23 which is most meaningful, comforting and indeed mind-boggling, which states “a virgin shall be with child and shall bear a Son, and they shall call His name Immanuel, which translated means ‘God with us’.” Imagine the eternal God of a myriad of universes can be so personal through Jesus His Son that He can truly be known individually. May we all experience this in 2014.
An August 11th, 2013 blog (below) on this website described how a chemotherapeutic drug such as docetaxel (taxotere) used in the treatment of advanced prostate cancer could be administered more effectively and with less side effects. Taxotere is a variant of an anti-cancer drug (taxol) originally isolated from yew plants.
Nanoparticles are chemical species which can serve as a targeted delivery system for drugs, proteins and other therapeutics. The drug to be delivered is contained within the nanoparticle whose surface is then coated with targeting moieties such as antibodies. The overall result is the delivery of a specific drug directly to the cancer cells thereby allowing for higher localized doses and minimized systemic side effects. This type of delivery system for docetaxel (taxotere) is given as an example in a video and accompanying article from the July 31st, 2013 issue of the Prostate Cancer Foundation NewsPulse. Docetaxel is a chemotherapy used in metastatic, hormone-refractory prostate cancer patients. While it is efficacious, it also can produce serious side effects. It is also limited in the amount of drug which can be administered intravenously. Therefore, nanoparticle delivery can be much more efficacious.