The Efficacy of Proclarix to Select Appropriate Candidates for Magnetic Resonance Imaging and Derived Prostate Biopsies in Men with Suspected Prostate Cancer
Morote Robles, Juan (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Campistol, Miriam (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Celma, Ana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Regis, Lucas (Hospital Universitari Vall d'Hebron. Institut de Recerca)
de Torres, Inés (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Semidey, María E. (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Roche, Sarai (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Mast, Richard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Santamaría, Anna (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Planas, Jacques (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Trilla Herrera, Enrique (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Data:	2021
Resum:	To analyze how Proclarix is valuable to appropriately select candidates for multiparametric magnetic resonance imaging (mpMRI) and derived biopsies, among men with suspected prostate cancer (PCa). Proclarix is a new marker computing the clinically significant PCa (csPCa) risk, based on serum thosmbospondin-1, cathepsin D, prostate-specific antigen (PSA) and percent free PSA, in addition to age, that has been developed in men with serum PSA 2 to 10 ng/mL, prostate volume ≥35 mL, and normal digital rectal examination (DRE). Proclarix score (0%-100%) is analyzed in a prospective frozen serum collection of 517 correlative men scheduled for guided and/or systematic biopsies after mpMRI. Outcome variables were csPCa detection (grade group ≥2), insignificant PCa (iPCa) overdetection and avoided mpMRIs. The area under the curve of Proclarix was 0. 701 (95% CI 0. 637-0. 765) among 281 men with serum PSA 2 to 10 ng/mL, prostate volume ≥35 mL, and -normal DRE, and 0. 754 (95% CI 0. 701-0. 807) in the others, p=0. 038. Net benefit of Proclarix existed in all men. After selecting 10% threshold, Proclarix was integrated in an algorithm which also used the serum PSA level and DRE. A reduction of 25. 4% of mpMRIs request was observed and 17. 7% of prostate biopsies. Overdetection of iPCa was reduced in 18. 2% and 2. 6% of csPCa were misdiagnosed. Proclarix is valuable in all men with suspected PCa. An algorithm integrating Proclarix score, serum PSA, and DRE can avoid mpMRI requests, unnecessary prostate biopsies and iPCa overdetection, with miniml loss of csPCa detection.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Clinically significant ; Diagnosis ; Multiparametric magnetic resonance imaging ; Proclarix ; Prostate cancer
Publicat a:	The world journal of men's health, Vol. 40 (december 2021) , p. 270-279, ISSN 2287-4690

DOI: 10.5534/wjmh.210117
PMID: 35021312

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