soon a simple urine test to diagnose the disease?

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Movember is male cancer awareness month; the opportunity to shine the spotlight on the HOPE trial, which aims to prove the reliability of a simple urine test to diagnose prostate cancer.

It is the most common cancer in men. Every year it affects nearly 60,000 men and causes 8,000 deaths. Worldwide, prostate cancer is expected to double by 2040, reaching 2.9 million cases.

No organized screening for prostate cancer

But unlike breast, cervical and colorectal cancers, there is currently no no organized screening for prostate cancer.

It can be detected using a digital rectal exam, PSA (prostate specific antigen) testing, magnetic resonance imaging (MRI) and, if necessary, a deep tissue biopsy. the prostate to confirm the diagnosis. This invasive, stressful and sometimes painful examination can also cause complications.

A trial, called “HOPE”, coordinated by the Institut Curie (Paris), could revolutionize the diagnostic approach to prostate cancer.

“The idea is to develop a simple, inexpensive way to detect and direct patients to appropriate treatments as early as possible,” summarizes Antonin Morillon, CNRS/Institut Curie research director of the “ARN” team. non-coding, epigenetics and genome fluidity”.

Detecting cancer in a urine sample

Antonin Morillon and his team, in collaboration with Professor Yves Allory, anatomopathologist at the Curie Institute, have developed a test capable of detecting new prostate cancer biomarkers in urine.

“Our trial, started in 2021, consists of proving the concept of the possibility of obtaining a rapid and non-invasive diagnosis of prostate cancer. This involves testing patients’ urine directly for the presence of robust markers of the disease. This is the first step: being able to detect prostate cancer in urine,” continues the researcher.

When the trial began in 2022, healthy participants were included, but also others with suspected prostate cancer. “Since then, we have known whether they actually suffered from cancer or benign prostatic hyperplasia,” specifies the researcher.

For each participant, urine samples were collected. “Today we have all the samples and all the clinical information. We are currently carrying out computer and statistical analyzes to define the molecular signature of prostate cancer. Within a few months, I hope we will be able to offer a tool for early diagnosis.”

The hidden face of the genome at the heart of research

What are these biomarkers that Antonin Morillon’s team is looking for in urinary samples?

Using next-generation molecular sequencing and artificial intelligence and bioinformatics algorithms, the team identified a set of uncatalogued sequencing overexpressed in prostate cancer.

“All of our cells have their own molecular identity. For tumors, it’s the same thing, explains the scientist. We find genes expressed in a specific manner compared to a normal prostate cell. »

Among these genes – identity signatures of tumors – there is the hidden side of the genome, non-coding DNA (a type of genetic material which is not translated into protein, editor’s note) which represents 98% of our chromosomes and for which we still have little information. These entire sections of DNA are terra incognita. And this hidden face is so vast that it multiplies the possibilities of obtaining specific signatures of a tumor.

Work to be consolidated

If the effectiveness of the test is proven, a new study could be launched. Objective this time: to be able to know the prognosis of cancer – high risk, intermediate risk or low risk.

Here again, a molecular signature could be identified and looked for directly in the urine. “And if the cancer is not invasive, we can preserve the prostate and do active surveillance, but in a simple way, thanks to a regular urine test to see if the cancer is progressing. It’s about being able to offer these tools to patients to avoid unnecessary biopsies. »

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