Extracellular Vesicles May Predict Prostate Cancer Risk

By Patrick Daly - Last Updated: November 30, 2022

Researchers explored whether prostate-derived extracellular vesicles (EVs) could function as a blood-based biomarker for better detection of clinically significant prostate cancer risk compared with multiparametric magnetic resonance imaging (mpMRI) alone.

In their report, presented at the 23rd Annual Meeting of the Society of Urologic Oncology, the investigators suggested that these EVs could be a promising biomarker to reduce the false positive rate of mpMRI and potentially spare patients from unnecessary prostate biopsies.

Prostate-Derived EV Test Improves Detection of Prostate Cancer

This prospective study included a total of 179 men with elevated prostate-specific antigen (PSA) levels. Of those patients, 102 (57%) had no prior biopsies, 39 (22%) had a prior negative biopsy, and 38 (21%) were on active surveillance.

The overall cohort had a median age of 65 years (interquartile range [IQR], 60-61 years) and median prebiopsy PSA level of 6.35 (IQR, 5.0-0.3). The primary end point was the accuracy of prostate-derived EVs and mpMRI, alone or in combination, for detecting clinically significant prostate cancer prior to prostate biopsy.

Reportedly, MRI alone had an area under the receiver operating characteristic curve (AUC) of 0.76 for identifying clinically significant prostate cancer, while the EV and MRI combined model had an AUC of 0.8028. Additionally, the authors observed that the addition of the EV test lowered the rate of false positives by 19% and missed only 6.3% of clinically significant cases compared with MRI alone.

Ultimately, the study’s authors proposed that “our work will serve as scientific justification for validation studies and investigation of other EV-based biomarkers in an effort to further improve the ability to detect [clinically significant prostate cancer] prior to biopsy.”