What’s unique about the Prolaris prognostic test?
Certified Urology Nurse Karen Kunz Transcript
Opening Title: What is unique about the Prolaris test?
The Prolaris test is a test that removes genetic material from prostate cancer cells and tells us about the aggressiveness of that prostate cancer. So the genes in Prolaris are cell cycle progression genes, also referred to as CCP genes, or proliferation genes. They are expressed in higher levels in cells that are actively dividing, so if there’s a higher level of expression of the CCP genes, that means that the cancer is more aggressive and it’s dividing more rapidly.
So the early biopsy studies were done on a group in the United Kingdom from six hospitals. The reason why those centers were chosen is they had a very high mortality rate. They were untreated, really not on active surveillance as we do it here, it was a watchful waiting, and 26% of those men died within ten years. It was important to look at tumors from these men, so that we could tell whether or not Prolaris would be able to tell us whether or not a man has a lethal prostate cancer. So the ten year study showed that when men had a higher Prolaris score they were likely to die from their prostate cancer.
So what we found is two men, prior to Prolaris, may look very similar. For example, they may have the same PSA, Gleason score, number of cores positive, but when they get the Prolaris results, they may have a very different mortality risk. For example, one man may have a 1 or 2% chance of dying from prostate cancer, while the other man has about a 12% chance of drying from prostate cancer, if they have very different Prolaris scores.
So Prolaris, unlike Gleason, tells you about what’s going to happen in the future. So Gleason score will tell you how far the cells have gotten so far, and what it looks at today, and the Prolaris score tells you what’s likely to happen in the future. So what is the potential of that tumor, it’s really what we’re looking for with Prolaris.
So about 8,000 Prolaris tests have been done thus far, and what we found is about half of the time a patient’s mortality risk will be consistent with what they already knew from their Gleason, and other clinical and pathologic features. However, about the other half are equally divided between more and less aggressive so about 25% of men have found that they have a more aggressive cancer on a molecular level and about 25% have found they have a much less aggressive cancer. So these patients have had the benefit of making more informed management decisions.
Closing Title: The Prolaris test can find potential aggressive prostate cancer!