IsoPSA Performance Characteristics are Unaffected by 5-Alpha Reductase Inhibitors or Alpha-Blockers: Results From the IsoPSA Validation Study

• Published in: Urology (Ridgewood, N.J.) N.J.), 2023-05, Vol.175, p.132-136
• Main Authors: Scovell, Jason M., Stovsky, Mark, Partin, Alan, Lotan, Yair, Baniel, Jack, Dineen, Martin, Hafron, Jason, Manickam, Kannan, Pliskin, Marc, Wagner, Matthew, Kestranek, Aimee, Klein, Eric A.
• Format: Article
• Language: English
• Subjects: 5-alpha Reductase Inhibitors - therapeutic use; Adrenergic alpha-Antagonists - therapeutic use; Humans; Male; Prospective Studies; Prostate-Specific Antigen; Prostatic Hyperplasia - complications; Prostatic Neoplasms - pathology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2023.01.037

To. determine the impact of 5-α reductase inhibitors or α-blockers on IsoPSA performance for the detection of actionable prostate cancer. This is a secondary analysis of data from an institutional review board approved, prospective, multicenter(8-sites) study evaluating IsoPSA in men ≥ 50 years of age with a total PSA ≥ 4 ng/mL with planned prostate biopsy who met previously described inclusion and exclusion criteria. Analytic groups included (i)all subjects, (ii-iii)+/- 5-ARI use, (iv-v)+/- α-blocker use. The performance characteristics of IsoPSA in these groups were assessed by ROC curve, sensitivity, and specificity (SP) analysis. A total of 1385 men were recruited with 888 men included in final analysis. Actionable prostate cancer, defined as GG2+, was identified in a total of 316 patients with 40 and 217 patients reporting 5-ARI and α-blocker use respectively. Sensitivity to detect both prostate cancer and actionable cancer was similar between patient subsets (P >.05). SP was similar between patients regardless of 5-ARI(P >.05). Increased SP was noted in patients on α-blockers(GG1+: No-α-blocker: 0.360 vs α-blocker: 0.529, P