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IsoPSA Performance Characteristics are Unaffected by 5-Alpha Reductase Inhibitors or Alpha-Blockers: Results From the IsoPSA Validation Study - 29/05/23

Doi : 10.1016/j.urology.2023.01.037 
Jason M. Scovell 1, Mark Stovsky 2, Alan Partin 3, Yair Lotan 4, Jack Baniel 5, Martin Dineen 6, Jason Hafron 7, Kannan Manickam 8, Marc Pliskin 9, Matthew Wagner 10, Aimee Kestranek 2, Eric A. Klein 1,
1 Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH 
2 Cleveland Diagnostics, Inc., Cleveland, OH 
3 Johns Hopkins James Buchanan Brady Urological Institute, Baltimore, MD 
4 Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 
5 Rabin Medical Center Department of Urology, Petah Tikvah, Israel 
6 Advanced Urology Institute, Daytona Beach, FL 
7 Michigan Institute of Urology, West Bloomfield, MI 
8 Chesapeake Urology Associates, Baltimore, MD 
9 The Urology Group, Cincinnati, OH 
10 Kaiser Permanente Northwest, Clackamas, OR 

Address correspondence to: Eric A. Klein, MD, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH.Cleveland ClinicGlickman Urological and Kidney InstituteClevelandOH

ABSTRACT

Objective

To. determine the impact of 5-α reductase inhibitors or α-blockers on IsoPSA performance for the detection of actionable prostate cancer.

Materials and Methods

This is a secondary analysis of data from an institutional review board approved, prospective, multicenter(8-sites) study evaluating IsoPSA in men ≥ 50 years of age with a total PSA ≥ 4 ng/mL with planned prostate biopsy who met previously described inclusion and exclusion criteria. Analytic groups included (i)all subjects, (ii-iii)+/- 5-ARI use, (iv-v)+/- α-blocker use. The performance characteristics of IsoPSA in these groups were assessed by ROC curve, sensitivity, and specificity (SP) analysis.

Results

A total of 1385 men were recruited with 888 men included in final analysis. Actionable prostate cancer, defined as GG2+, was identified in a total of 316 patients with 40 and 217 patients reporting 5-ARI and α-blocker use respectively. Sensitivity to detect both prostate cancer and actionable cancer was similar between patient subsets (P >.05). SP was similar between patients regardless of 5-ARI(P >.05). Increased SP was noted in patients on α-blockers(GG1+: No-α-blocker: 0.360 vs α-blocker: 0.529, P <.05; GG2+: No-α-blocker: 0.40 vs α-blocker: 0.61, P <.05). ROC analysis demonstrates that IsoPSA performance is unaffected by 5-ARI or α-blocker use for prostate cancer and actionable cancer (GG2+) detection.

Conclusion

The performance of IsoPSA for detecting any prostate cancer and clinically actionable prostate cancer is unaffected by commonly used medications (5-ARI and α-blockers) for symptoms of benign prostatic hyperplasia.

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 Financial Disclosure: AK and MS are employees of Cleveland Diagnostics, Inc. and hold equity positions in the company. JS and EAK are employees of the Cleveland Clinic, which holds an equity stake in Cleveland Diagnostics, Inc. EAK is a consultant to Cleveland Diagnostics. Cleveland Diagnostics, Inc. provided funding for study logistics and performed IsoPSA on clinical plasma specimens collected at study sites. Cleveland Diagnostics, Inc. participated in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation and review of the manuscript.


© 2023  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 175

P. 132-136 - mai 2023 Regresar al número
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