On the front page of our last issue of Discovery, we covered a major breakthrough — a new test for prostate cancer, called EPCA-2, that has proven to be more specific than PSA. The marker was found by a research team led by Robert H. Getzenberg, Ph.D., the Donald S. Coffey Professor of Urology, in work published in the April 2007 Urology. In early tests, EPCA-2 did a better job than PSA at distinguishing men with prostate cancer from other men, and of showing which men had organ-confined cancer, and which men had cancer that had spread beyond the prostate.

EPCA-2 proved better than PSA
at distinguishing men with
prostate cancer from other men,
and of showing which men had
organ-confined cancer, and which
men had cancer that had spread.

In further tests, the marker has been able to distinguish cancer from BPH and prostatitis — two conditions that can elevate PSA, and confuse a diagnosis of cancer. Most recently, Getzenberg and colleagues analyzed blood samples, provided by Children’s Hospital in Boston, of men with prostatitis, and “we demonstrated that blood-based EPCA-2 levels are not elevated in these men,” Getzenberg says. “Previously, we found that the levels were not elevated in men with BPH.” In other studies, “the separation between men with organ-confined and non-organ-confined disease continues to be dramatic.” While PSA has some ability to tell whether a man’s prostate cancer is advanced — for example, the risk of having advanced prostate cancer goes up as PSA increases from 4 to 10 to greater than 20 — EPCA-2 is significantly more accurate.

More studies are needed before the test can be approved for clinical use, but the results “continue to support that EPCA-2 is highly specific for prostate cancer, is found in higher levels in men with disease that has spread outside the prostate, and that it may serve as a means to target drugs specifically to prostate cancer. The next year should be an exciting one as many of these studies are completed.”