What information can a PCA3 urine test provide in the diagnosis and treatment of prostate cancer?

The Prostate CAncer gene 3 (PCA3 or DD3) is a promising urinary, gene-based, prostate cancer biomarker. This specific non-coding mRNA sequence is highly over expressed in more than 95% of primary prostate tumors. The feasibility of a PCA3 gene-based molecular assay for the detection of prostate cancer (PCa) cells in the urine has been demonstrated, and, recently, a quantitative PCA3 urine test with the potential for general use in clinical settings has been developed. Thus, current data from the literature are now available which demonstrate the superiority of the PCA3 score over prostate-specific antigen (PSA) level, at least in terms of predictive value and specificity but with a slightly lower sensitivity. These results are particularly encouraging for the specific population of patients who initially have a negative biopsy result, as using a PCA3 assay would allow them to avoid unnecessary repeated biopsies. Finally, this review discusses the limited data available that demonstrates a correlation between PCA3 score and tumor volume, extra capsular extension and the ability to distinguish indolent from significant cancer.