Prostate matters is a not for profit organisation committed to providing free information about prostate issues from leading Clinical Authorities.
Proclarix – a geonomic test for inconclusive MRI results
Professor of Interventional Oncology, Division of Surgery
and Dean of UCL Faculty of Medical Sciences
University College Hospital London, NHS Trust
When to use Proclarix
When a radiologist reports a prostate MRI, they often use the Prostate Imaging-Reporting and Data System (PI-RADS) to evaluate the likelihood of harbouring clinically significant prostate cancer, alternatively they may use the Likert scoring system. In both cases a scoring scale of 1-to-5, where a score of 1 or 2 indicates that the presence of clinically significant disease is highly unlikely while a score of 4 or 5 means that it is highly likely and a biopsy should be performed. However a score of 3 entails that the MR findings are equivocal, that is it is unclear whether there is significant disease or not. Often a biopsy is performed to establish certainty one way or another.
However a biopsy is not pleasant or without risks and it is preferable to avoid having to perform a biopsy if at all possible. This is where Proclarix comes into the picture.
When combined with the mpMRI and prostate volume, Proclarix can reliably predict the presence of prostate cancer and can rule out men with no or indolent cancer.
Some studies have shown that this can lead to a large reduction of up two thirds in unnecessary biopsies performed.
In conclusion, Proclarix can be used with high confidence to reliably detect significant cancer in men with an indeterminate PI-RADS or Likert score of 3 following their MRI.
What is Proclarix?
Proclarix is a blood test based on two novel biomarkers, thrombospondin 1 (THBS1) and cathepsin D (CTSD), combined with PSA and age. A software algorithm returns a risk score that can be used as an aid in the identification of clinically significant prostate cancer. It returns a Risk Score corresponding to the probability of detecting high-grade (Gleason score 7 or higher) prostate cancer based on a prostate biopsy.
Therefore it is a great aid in determining who should have a biopsy and who should not.
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