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New Test May Predict Prostate Cancer's Aggressiveness
Date:4/19/2010

e been clipped off. It is the pro-PSA level that is most valuable as a predictor, Veltri said, but it is only one part of the study.

The new PSA test is given twice a year, along with a digital rectal exam to determine the size of the tumor, and a yearly biopsy. The regimen found unfavorable indications for 39 of the cancers -- meaning progression of cancer grade or tumor size -- and favorable for the 32 others, Veltri said. "When you combine the DNA reading and the serum Prostate Health Index, it is accurate in about 7 out of 10 cases," he said.

But it was a small study, and "it will take another year or two to get enough cases to nail down the predictive index," Veltri said.

The Hopkins group is trying to identify other biomarkers that would improve the program's predictive value, he said. One hope is that the now-annual biopsies could be done every other year, Veltri said.

The study results have caused "excitement," he said. "Through active surveillance, we can identify a set of prostate cancer patients with low-grade tumors that may be able to have intervention deferred or delayed," Veltri said.

The Hopkins work was described as "outstanding" by Dr. William J. Catalona, director of the prostate cancer program at Northwestern Memorial Hospital's Robert H. Lurie Comprehensive Cancer Center, who pioneered the use of the standard PSA test and helped develop the new version of the test.

The test is awaiting approval by the U.S. Food and Drug Administration and already is approved for use in Europe, Catalona said. In a study of 2,000 men in the Chicago area, "we found it to be more accurate than the tests now available, and it also seems to identify the more aggressive prostate cancers," he said.

Another report at the same meeting described use of a microchip to detect tumor cells in the blood of people with prostate cancer. The presence of circulating cells can indicate spread of the cancer to oth
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