Early Detection of Prostate Cancer

In this preclinical validation study patients suspicious of prostate cancer who will undergo initial prostate biopsy are going to be asked for blood samples during a routine visit. Each patient will have had an MRI (Magnetic Resonance Imaging) as part of the care before performing the biopsy. The investigators will draw a total of 49 ml peripheral blood from consented patients before the initial diagnostic biopsy is taken. Within this project, validation of liquid biopsy assays for early detection of prostate cancer patients is the primary goal.

In order to determine CTC numbers, 21 ml of blood will be subjected to either CTC-Capture, and 28 ml for the EPIDROP analysis according to standard protocol (For analysis of circulating blood products plasma, analysis of tumor specific mutations or promotor methylation, analysis of extracellular vesicles and microRNA). The investigators will also analyze the Prostate Health Index marker from the additional EDTA tube (7 ml).

The investigators will assess whether CTC counts and/or detection of tumor specific blood products will provide discrimination between the men with histologically proven prostate cancer and agematched non-cancer controls as well as identification of high-risk PCa patients.

Furthermore, the investigators will compare results from tested liquid biopsy assay with current standard of early prostate cancer detection using both serum PSA and digital rectal examination, MRImp and PSA density.

The discovery phase is a non-blind study on 70 subjects with elevated PSA, and 50 negative controls (Healthy patients no suspicion of prostate cancer; PSA<2.5). The 70 patients are patients with suspected prostate cancer and will undergo prostate biopsy.

The samples will be tested for the 3 biomarkers (CTCs, cfDNA, exosome). The validation study is a non-blind study on 167 subjects with elevated PSA and designated for a biopsy (this biopsy may be positive (presence of cancer) or negative (no cancer revealed by the biopsy)), and 33 negative controls. The samples will be tested with the best biomarkers or biomarker combination selected in the discovery phase.

Inclusion criteria

Patient :

• Men over 40 being suspicious of prostate cancer
• Subject with PSA ≥ 4 and designated for biopsy
• Subjects must be able to attend all scheduled visits and to comply with all trial procedures
• mpMRI done before prostate biopsy
• Subject must be covered by public health insurance
• Signed informed consent form

Inclusion criteria

Subject Control Patient patient free from prostatic disease :

• Men over 40 with no suspicion of prostate cancer
• Subject with PSA < 2.5 and normal digital rectal examination
• Subject must be covered by public health insurance
• Signed informed consent form

Exclusion criteria

Patient :

• Subject with histologically confirmed prostate cancer
• Subject with a verified viral infection (HIV or Hepatitis)
• Subject under Finasteride treatment
• Subject under hormonal treatment (analogs, antagonists, androgenics)
• Subject with other cancer diagnosed
• Subject unable to sign consent
• Planned longer stay outside the region that prevents compliance with the visit plan
• Subject deprived of liberty, protected adults or vulnerable persons
• Urinary infection ≤ 2 months
• Subject excluding health insurance registration
• Subject refusing to perform prostate biopsy
• Subject who are in a dependency or employment with the sponsor or the investigator

Exclusion criteria

Subject Control :

• Subject with histologically confirmed prostate cancer
• Subject with a verified viral infection (HIV or Hepatitis)
• Subject under Finasteride treatment
• Subject with other cancer diagnosed
• Subject unable to sign consent
• Planned longer stay outside the region that prevents compliance with the visit plan
• Subject deprived of liberty, protected adults or vulnerable persons
• Urinary infection ≤ 2 months
• Subject excluding health insurance registration