# Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer

Source: https://onco.cc/key-papers/paper-tosoian-18-gene-urine-prostate-jama-oncol-2024/  
OnCo record `paper-tosoian-18-gene-urine-prostate-jama-oncol-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The development and validation of an 18-gene urine test that outperformed the blood PSA test at finding prostate cancers worth treating.

## Summary

In a validation cohort of 743, the area under the curve was 0.81 for MPS2 and 0.82 for MPS2+, against 0.60 for PSA alone and 0.77 for the Prostate Health Index, with negative predictive values of 95 to 99 per cent for grade group 2 or higher cancer.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Journal: JAMA Oncology
- Year: 2024
- DOI: 10.1001/jamaoncol.2024.0455
- Authors: Tosoian JJ, Zhang Y, Xiao L, et al.
- Findings: Area under the curve 0.81 to 0.82 against 0.60 for PSA.; Negative predictive value 95% to 99%.
- What it means: A urine RNA panel can rule out significant prostate cancer for many men.
- Caveats: Validation within a research network; MRI not used for everyone.

## Sources

- Tosoian et al., JAMA Oncol 2024: https://doi.org/10.1001/jamaoncol.2024.0455
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38635241/

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)
- technologies: [Liquid RNA biopsy (cell-free, vesicle and platelet RNA)](https://onco.cc/technologies/liquid-rna-biopsy/), [PSA and MRI-first prostate cancer screening](https://onco.cc/technologies/prostate-screening-psa-mri/)
- drugs: [MyProstateScore 2.0](https://onco.cc/drugs/myprostatescore-2/)
- terms: [Biomarker](https://onco.cc/terms/biomarker/)

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