ECPA-2 test (prostate cancer antigen-2 )

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http://www.forbes.com/forbeslife/health/feeds/hscout/2007/04/26/hscout604042.html

Better Prostate Cancer Test May Be Near
04.26.07, 12:00 AM ET

THURSDAY, April 26 (HealthDay News) -- A test that focuses on a blood
protein produced by prostate cancer cells may improve disease diagnosis,
researchers report.

Levels of this protein, called prostate cancer antigen-2 (EPCA-2), appear
to give a more accurate picture of cancer present in the body, experts
say.

"We've been able to show that blood levels of it are low in normal
individuals and high in prostate cancer, and that it distinguishes between
cancers that are confined to the prostate and those that have spread
outside the gland," explained study lead researcher Dr. Robert H.
Getzenberg, professor of urology and director of research at Johns Hopkins
University's James Buchanan Brady Urological Institute, in Baltimore.

His team published its findings in the May issue of Urology.

Prostate cancer is the most common malignancy in American men. There will
be some 218,890 new cases in the United States this year and 27,050 deaths
linked to the disease, the American Cancer Society estimates. Prostate
cancer is highly curable if caught early, however.

In the new study, Getzenberg's team measured blood levels of EPCA-2 in 330
men. Some of the men had an enlarged but non-cancerous prostate gland,
some had prostate cancer but displayed normal PSA levels, some had
prostate cancer that had spread beyond the gland, and some had other
cancers or medical conditions.

A specific level of ECPA-2 identified 90 percent of the men with cancer
confined to the prostate and 98 percent of those in whom it had spread
outside the gland. The test was negative in 97 percent of the men without
prostate cancer, the researchers said.

That's an improvement on the standard PSA test, which provides only a
rough guide in many such cases. For example, a high blood level of PSA can
sometimes indicate prostate cancer, but often a biopsy reveals no such
malignancy.

Conversely, a low PSA level does not necessarily mean that a man is free
of prostate cancer, the researchers said.

"If this test works out, we can avoid a lot of unnecessary biopsies,"
Getzenberg said. About 1.3 million men in the United States will have
biopsies this year to find only 200,000 cancers, he noted.

"Clearly, we need further validation," Getzenberg added. "We are doing
good-sized validation studies, and we are also testing the ability of the
marker to identify aggressive forms of the disease."

Spotting especially life-threatening prostate tumors is "the holy grail"
of diagnosis, he said. Current PSA testing cannot distinguish between
cancers that will grow so slowly that they pose no danger to life and
those that require quick action. The hope is that the ECPA-2 test will
identify men whose slow-growing cancers make them candidates for "watchful
waiting" rather than immediate surgery or other treatment.

The Hopkins team, working with researchers from the University of
Pittsburgh, has licensed the test to a company, Onconome Inc. The ECPA-2
screen is a simple antibody test requiring "no special kind of technology
or equipment," Getzenberg noted.

"We have already met with the Food and Drug Administration and understand
the kind of trial we need to do [for approval]," he said. "We want to get
the necessary papers out over the next six to nine months." That means
that the test might be available in the next 18 months, the researcher
said.

The Hopkins team is now working with tissue samples from three other
medical centers, "trying to broaden the types of samples we have,"
Getzenberg added.

"In general, it does look very promising," Dr. Durado Brooks, director of
prostate and colorectal cancers at the American Cancer Society, said of
the ECPA-2 test. But much more work must be done, he added.

"It does seem to have very high sensitivity and specificity for prostate
cancer," Brooks said. "The challenge is taking it out of this isolated and
rigorous setting and seeing how it performs in other laboratories and also
in much larger screening-type populations."

If the test does prove to be accurate in larger populations, it could be
"very useful" in prostate cancer diagnosis, Brooks said. But the real hope
that it could single out those cases requiring immediate treatment from
those that could be left for watchful waiting has yet to be proved, he
said.

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Thu. Aug. 24 2006

While the PSA test does pick up many cases, it's also known to find signs
of cancer where there may be simply an infection and ends up sending many
men into surgery when they don't have cancer.

Conversely, the test can give men the all clear when there is actually a
cancer growing.

That is why many doctors are welcoming news of the early prostate cancer
antigen-2 (EPCA-2) -- a blood test that seems to be more accurate and has
the ability to detect prostate cancer early.

When a cancer forms in the prostate, which sits below the bladder, the
cancer cells emit a protein into the blood that's not found in healthy
cells.

Tested on about 330 men, researchers found:

EPCA-2 correctly identified men with no prostate cancer 97 per cent of the
time; and

The test was 94 per cent accurate in detecting men with the disease.

In comparison, the current PSA test shows it detects cancer in 85 per cent
of men who have it.

"I think this is a promising test," cancer specialist Dr. Robert Bristow,
of the Prostate Cancer Research Foundation of Canada, told CTV News in
Toronto.

"Having a test that is more accurate to only give biopsies to those
patients who truly are most likely to have cancer, and prevent the other
80 per cent of patients who do not have cancer undergoing those biopsies."

Further, the new test seems to be able to tell doctors if the cancer has
spread outside the prostate -- helping them decide which men require more
aggressive drug treatment or radiation.

"This is important since cancer that has spread outside of the prostate is
more deadly, which makes it even more crucial to have a tool that detects
it early," said Getzenberg.


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