title: Racial Variation in the Utility of Urinary Biomarkers PCA3 and T2ERG in a Large Multicenter Study.
abstract: To our knowledge it is unknown whether urinary biomarkers for prostate cancer have added utility to clinical risk calculators in different racial groups. We examined the utility of urinary biomarkers added to clinical risk calculators for predicting prostate cancer in African American and nonAfrican American men.
  
  
  
  Demographics, PCPT (Prostate Cancer Prevention Trial) risk scores, data on the biomarkers data PCA3 (prostate cancer antigen 3) and T2ERG (transmembrane protease serine 2 and v-ets erythroblastosis virus E26 oncogene homolog gene fusion), and biopsy pathology features were prospectively collected on 718 men as part of EDRN (Early Detection Research Network). Utility was determined by generating ROC curves and comparing AUC values for the baseline multivariable PCPT model and for models containing biomarker scores.
  
  
  
  PCA3 and T2ERG added utility for the prediction of prostate cancer and clinically significant prostate cancer when combined with the PCPT Risk Calculator. This utility was seen in nonAfrican American men only for PCA3 (AUC 0.64 increased to 0.75 for prostate cancer and to 0.69-0.77 for clinically significant prostate cancer, both p <0.001) and for T2ERG (AUC 0.64-0.74 for prostate cancer, p <0.001, and 0.69-0.73 for clinically significant prostate cancer, p = 0.029). African American men did not have an added benefit with the addition of biomarkers, including PCA3 (AUC 0.75-0.77, p = 0.64, and 0.65-0.66, p = 0.74) and T2ERG (AUC 0.75-0.74, p = 0.74, and 0.65-0.64, p = 0.88), for prostate cancer and clinically significant prostate cancer, respectively. Limitations include the small number of African American men (72). The post hoc subgroup analysis nature of the study limited findings to being hypothesis generating.
  
  
  
  As novel biomarkers are discovered, clinical utility should be established across demographically diverse cohorts.
authors.affiliation: Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York. Electronic address: pao9029@med.cornell.edu.
authors.forename: Padraic G
authors.initials: PG
authors.lastname: O'Malley
authors.affiliation: Department of Urology, Universität Bern, Bern, Switzerland.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Nguyen
authors.affiliation: Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Bashir
authors.initials: B
authors.lastname: Al Hussein Al Awamlh
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Guojiao
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.affiliation: Department of Urology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Martin
authors.initials: M
authors.lastname: Sanda
authors.affiliation: Department of Pathology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Rubin
authors.affiliation: Department of Urology, University of Michigan, Livonia, Michigan.
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.affiliation: Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Paul
authors.initials: P
authors.lastname: Christos
authors.affiliation: Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Christopher
authors.initials: C
authors.lastname: Barbieri
authors.affiliation: Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Scherr
mesh_terms: D001741:Black or African American; D000951:Antigens, Neoplasm / Q000652:urine*; D014408:Biomarkers, Tumor / Q000652:urine*; D006801:Humans; D008297:Male; D015514:Oncogene Proteins, Fusion / Q000652:urine*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000652:urine*; D050787:Proto-Oncogene Protein c-ets-2 / Q000652:urine*; D018570:Risk Assessment; D012697:Serine Endopeptidases / Q000652:urine*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015514:Oncogene Proteins, Fusion; D050787:Proto-Oncogene Protein c-ets-2; D012697:Serine Endopeptidases; C494069:ETS2 protein, human; C479341:prostate cancer antigen 3, human; C421305:TMPRSS2 protein, human
keywords: African Americans; biomarkers; gene fusion; human; prostate cancer antigen 3; prostatic neoplasms; tumor