Two new tests are now available that screen material from biopsy samples. One attempts to reduce the possibility of false negatives in a biopsy that had a negative result for cancer. The ConfirmMDx test essentially increases the range of a biopsy sample, allowing the laboratory to detect cancer from genetic markers in tumors that may not have been directly sampled and otherwise missed. This can reduce the need to retest in a future biopsy. From Reuters.com:
“When a prostate biopsy is performed for appropriate indications, there may be concern that the cancer may have been missed, despite the usual 10-14 core sampling. Tests which can improve the negative predictive value for a 1st time biopsy have clinically significant benefit, thus potentially avoiding unnecessary repeat biopsies,” said Neal Shore, MD, FACS, CPI, Medical Director at the Carolina Urologic Research Center. “ConfirmMDx is a valuable addition to our armamentarium and addresses an unmet need in diagnostic evaluation. Many men are subjected to unnecessary repeat biopsies, with the attendant morbidity and cost, as a result of an elevated PSA as well as the concern of missing an undetected cancer. ConfirmMDx assists in the avoidance of unnecessary repeat biopsies.”
The second test, Oncotype DX, uses genetic information on a positive biopsy result to help distinguish aggressive prostate cancer from slow growing tumors. This may help a patient and physician choose a treatment plan. From Reuters.com:
“The results of our study showed that the individual biological information from the Oncotype DX prostate cancer test tripled the number of patients who can more confidently consider active surveillance and avoid unnecessary treatment and its potential side effects. The test also identified a smaller number of patients who, despite seemingly low-risk clinical factors, had more aggressive disease and, would suggest that they consider immediate treatment,” said Peter Carroll, M.D., MPH, professor and chair, Department of Urology, UCSF and principal investigator of this validation study. “With these new study results, I believe we may be able to significantly increase the use of active surveillance, which has been limited to some extent by the absence of a validated genomic tool to more accurately distinguish low and high risk disease at the time of biopsy.“