Researchers at Johns Hopkins say they have developed a promising new way to detect prostate cancer using urine, a breakthrough that could reduce the need for invasive biopsies.
The test, created by scientists at the Johns Hopkins Kimmel Cancer Center, Johns Hopkins All Children’s Hospital, and several partner institutions, relies on three specific biomarkers found in urine: TTC3, H4C5, and EPCAM. These indicators were present in patients with prostate cancer before surgery and nearly absent after prostate removal, confirming their origin in prostate tissue.
In trials, the urine-based panel showed strong accuracy. It correctly identified prostate cancer 91 percent of the time and ruled out cancer in non-patients 84 percent of the time.
Researchers also found it worked in cases where the standard prostate-specific antigen (PSA) blood test failed, maintaining accuracy in more than 78 percent of PSA-negative cancers in the development study and nearly 86 percent in the validation study. Results were published Sept. 2 in eBioMedicine.
Dr. Ranjan Perera, the senior author and director of the Center for RNA Biology at Johns Hopkins All Children’s Hospital, said current PSA testing is not specific enough and often leads to unnecessary biopsies. “In many cases, these biopsies are negative and can result in unintended complications,” Perera noted. PSA testing can also result in treatment for very low-grade cancers that are unlikely to spread.
By contrast, the new urine test distinguishes prostate cancer from benign conditions such as prostatitis and benign prostatic hyperplasia (BPH). It also outperformed PCA3, another biomarker used for detection.
Dr. Christian Pavlovich, professor of urologic oncology at Johns Hopkins, said, “Most urologists feel that an accurate urinary biomarker would be a valuable addition to our current diagnostic armamentarium.”
The research involved studying more than 1,300 urine samples from healthy individuals, prostate cancer patients, and men who had undergone prostate-removal surgery. Using RNA sequencing and other advanced methods, scientists narrowed down from over 800 prostate-specific genes to the three most reliable biomarkers.
Prostate cancer is one of the leading causes of cancer-related deaths in American men. Currently, a PSA level above 4.0 nanograms per milliliter can trigger a biopsy recommendation, a process that is invasive, uncomfortable, and not always conclusive. Experts say a noninvasive urine test could transform early detection and reduce unnecessary procedures.
Dr. Vipul Patel, a co-author from AdventHealth Cancer Institute, called the results encouraging. “This test has the potential to help physicians improve diagnostic accuracy of prostate cancer, reducing unnecessary interventions while allowing early treatment for those who need it,” Patel said.
The next step for the Johns Hopkins team is independent trials at other institutions and development of the test for laboratory and clinical use. Johns Hopkins Technology Ventures is working with researchers to spin off a company to move the technology forward, and a patent has already been filed.