title: Urinary TMPRSS2:ERG and PCA3 in an active surveillance cohort: results from a baseline analysis in the Canary Prostate Active Surveillance Study.
abstract: OBJECTIVE
  Active surveillance is used to manage low-risk prostate cancer. Both PCA3 and TMPRSS2:ERG are promising biomarkers that may be associated with aggressive disease. This study examines the correlation of these biomarkers with higher cancer volume and grade determined at the time of biopsy in an active surveillance cohort.
  
  
  METHODS
  Urine was collected after digital rectal examination prospectively as part of the multi-institutional Canary Prostate Active Surveillance Study (PASS). PCA3 and TMPRSS2:ERG levels were analyzed in urine collected at study entry. Biomarker scores were correlated to clinical and pathologic variables.
  
  
  RESULTS
  In 387 men, both PCA3 and TMPRSS2:ERG scores were significantly associated with higher volume disease. For a negative repeat biopsy, and 1% to 10%, 11% to 33%, 34% or more positive cores, median PCA3, and TMPRSS2:ERG scores increased incrementally (P < 0.005). Both PCA3 and TMPRSS2:ERG scores were also significantly associated with the presence of high-grade disease. For a negative repeat biopsy, Gleason 6 and Gleason ≥7 cancers, the median PCA3, and TMPRSS2:ERG scores also increased incrementally (P = 0.02 and P = 0.001, respectively). Using the marker scores as continuous variables, the ORs for a biopsy in which cancer was detected versus a negative repeat biopsy (ref) on modeling was 1.41 (95% CI: 1.07-1.85), P = 0.01 for PCA3 and 1.28 (95% CI: 1.10-1.49), P = 0.001 for TMPRSS2:ERG.
  
  
  CONCLUSIONS
  For men on active surveillance, both PCA3 and TMPRSS2:ERG seem to stratify the risk of having aggressive cancer as defined by tumor volume or Gleason score.
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, Washington 98195, USA. dlin@u.washington.edu
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Lin
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Newcomb
authors.forename: Elissa C
authors.initials: EC
authors.lastname: Brown
authors.forename: James D
authors.initials: JD
authors.lastname: Brooks
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
authors.forename: Ziding
authors.initials: Z
authors.lastname: Feng
authors.forename: Martin E
authors.initials: ME
authors.lastname: Gleave
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Lance
authors.forename: Martin G
authors.initials: MG
authors.lastname: Sanda
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.forename: Peter S
authors.initials: PS
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000652:urine*; D014408:Biomarkers, Tumor / Q000652:urine*; D062665:Epidemiological Monitoring; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015514:Oncogene Proteins, Fusion / Q000652:urine*; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology / Q000652:urine*; D012372:ROC Curve; D012016:Reference Values; D018709:Statistics, Nonparametric; D047368:Tumor Burden
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015514:Oncogene Proteins, Fusion; C515553:TMPRSS2-ERG fusion protein, human; C479341:prostate cancer antigen 3, human