{"entity":{"id":"paper-mckiernan-urine-exosome-prostate-jama-oncol-2016","kind":"paper","name":"A Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer at Initial Biopsy","aka":[],"tldr":"The validation of a three-gene urine vesicle test that predicted high-grade prostate cancer at first biopsy better than standard clinical factors alone.","summary":"In independent validation in 519 patients, the urine exosome assay plus standard of care had an area under the curve of 0.73 (95% CI 0.68 to 0.77) against 0.63 for standard of care alone; 138 of 519 biopsies (27 per cent) would have been avoided, missing 5 per cent of patients with dominant pattern 4 high-risk Gleason 7 disease.","asOf":"2026-11-04","links":[{"label":"McKiernan et al., JAMA Oncol 2016","url":"https://doi.org/10.1001/jamaoncol.2016.0097"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27032035/"}],"tags":[],"related":[],"cancers":["prostate"],"sections":["diagnostics"],"technologies":["liquid-rna-biopsy"],"targets":[],"drugs":["exodx-prostate"],"companies":[],"institutions":[],"pathways":[],"terms":["biomarker"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2016,"doi":"10.1001/jamaoncol.2016.0097","pmid":"27032035","authors":"McKiernan J, Donovan MJ, O'Neill V, et al.","paperType":"translational","findings":["Area under the curve 0.73 against 0.63.","27% of biopsies avoidable."],"whatItMeans":"A urine RNA test can help some men skip a first prostate biopsy.","caveats":["Industry-sponsored; before MRI-first pathways were routine."],"participants":519},"route":"/key-papers/paper-mckiernan-urine-exosome-prostate-jama-oncol-2016/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"}],"technology":[{"id":"liquid-rna-biopsy","kind":"technology","name":"Liquid RNA biopsy (cell-free, vesicle and platelet RNA)","route":"/technologies/liquid-rna-biopsy/"},{"id":"prostate-screening-psa-mri","kind":"technology","name":"PSA and MRI-first prostate cancer screening","route":"/technologies/prostate-screening-psa-mri/"}],"drug":[{"id":"exodx-prostate","kind":"drug","name":"ExoDx Prostate (IntelliScore)","route":"/drugs/exodx-prostate/"}],"term":[{"id":"biomarker","kind":"term","name":"Biomarker","route":"/terms/biomarker/"}]}}