Project 462401

Early detection and diagnosis of prostate cancer still needs significant improvement. Too many men are erroneously submitted to an invasive biopsy procedure that will reveal no evidence of cancer. More than half of biopsy procedures done in Canada and the United States could be avoided if the right system and blood tests were in place to screen men. To address this, we have developed a blood test that when combined with magnetic resonance imaging (MRI) of the prostate, could significantly minimize this biopsy error rate. This blood test could replace the prostate specific antigen (PSA) test because it is 85% specific for aggressive prostate cancer whereas PSA is only 60% specific for aggressive prostate cancer. Much of the blame for erroneous needle biopsies in men should be placed on the PSA test. Our blood test is based on the counting of prostate cancer cell fragments that are present in a patient blood sample. However, we acknowledge that an accuracy rate of 95% or higher is needed and therefore we think this is possible if our blood test is used in combination with mpMRI of the prostate. We hypothesize that when a patient's blood sample is analyzed with our blood test and then submitted to mpMRI, we will be able to identify patients that need the biopsy at a 95% or higher rate of accuracy. This is because MRI is already 88% accurate but misses various types of prostate cancer that only our blood test is able to identify regardless of size or spread. This combination of liquid biopsy and MRI should result in more accurate and precise management of men with suspected prostate cancer. This proposal will attempt to show that with our blood test, we can improve accuracy rates beyond 95%. This could lead to significantly decreased cancer anxiety, more cost savings because of fewer hospitalizations from biopsies, improved public confidence in early detection in prostate cancer, and diverting more resources to treat patients in need more quickly.