Non-Invasive Urine Test Predicts Grade Group Upgrading in Patients on Active Surveillance for Prostate Cancer - Multisite Validation and Comparison with MRI

Sep 23, 2026

The study evaluates a non-invasive urine test for predicting Grade Group upgrading in men with prostate cancer managed on active surveillance. It reports multisite validation results and compares test performance with magnetic resonance imaging (MRI) to assess agreement and potential clinical utility. The work focuses on risk stratification for patients whose disease may progress while avoiding unnecessary invasive procedures, supporting more precise decision-making in active surveillance programs.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Background and Objective

Multisite Validation

Comparison With MRI

Clinical Implications for Active Surveillance

Author Manuscript Author Manuscript Author Manuscript Author Manuscript | | HHS Public Access
Author manuscript
J Urol. Author manuscript; available in PMC 2026 July 09. | | --- | --- | Published in final edited form as: J Urol. 2026 September ; 216(3): 369–379. doi:10.1097/JU.0000000000005095 . Non-Invasive Urine Test Predicts Grade Group Upgrading in Patients on Active Surveillance for Prostate Cancer: Multisite Validation and Comparison with MRI * Jeffrey J. Tosoian, MD, MPH , Department of Urology, Vanderbilt University Medical Center; Vanderbilt-Ingram Cancer Center, Nashville, TN Jacob I. Meyers, PhD* , Lynx Dx, Ann Arbor, MI Bradley Moore, MPH, Lynx Dx, Ann Arbor, MI Cameron J. Britton, MD, Department of Urology, Vanderbilt University Medical Center, Nashville TN Kent Chevli, MD, Western New York Urology Associates, Cheektowaga, NY Walter Rayford, MD, PhD, MBA, The Urology Group, Memphis, TN Adam J. Gadzinski, MD, MS, Comprehensive Urology, Royal Oak, MI Jean V. Joseph, MD, MBA, FACS, Department of Urology, University of Rochester Medical Center, Rochester, NY Pratik Patel, MD, Arizona State Urological Institute (ASUI) and Arizona State Urological Research Institute (ASURI), Gilbert, AZ This work is licensed under a Creative Commons Attribution 4.0 International License, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. Corresponding Author Information: Jeffrey J. Tosoian, MD, MPH, Department of Urology, Vanderbilt University Medical Center, A* C- 3-02firsMedit authcoCenter North, 1161 21st Avenue South Nashville, TN 37232-2765, Fax: 615-322-8990, [jeff.tosoian@vumc.org](jeff.tosoian@vumc.org). Disclosures: Dr. Barocas reported being on the advisory board for Pfizer, Lantheus, Lynx Dx, and Pacific Edge. Dr. Chinnaiyan reported serving on the advisory boards of Tempus, Ascentage Pharmaceuticals, Medsyn therapeutics, Esanik, and RAAPTA therapeutics. Drs. Chinnaiyan and Tosoian reported being scientific advisors and equity holders to Lynx Dx. Dr. Cooperberg reported being scientific advisor to Tempus, Veracyte, GlaxoSmithKline, Pfizer, Bayer, and Janssen as well as equity holding in Lynx Dx. Dr. Morgan reported being on the advisory board for Cleveland Diagnostics. Dr. Palapattu reported being on the advisory board for Continuity Biosciences, SynDevRx, Taurus Diagnostics, and Lynx Dx, and investment in Continuity Biosciences and ImmunityBio. Dr. Ross reported being a consultant or speaker for Astellas, Blue Earth, Bayer, Janssen, Pfizer, BilliontoOne, Lantheus, Veracyte, and Boston Scientific. Dr. Salami reported being on the advisory committee for Bayer Pharma. Dr. Salari reported research funding support from Convergent Genomics. Dr. Meyers, Mr. Moore, Dr. Cao, Mr. Bala, Mr. Oh, Dr. Heaton reported being employees of Lynx Dx. No other conflicts of interest were reported. Author Manuscript Author Manuscript Author Manuscript Author Manuscript Tosoian et al. Page 2 Ali Kasraeian, MD, MHA, FACS, Kasraeian Urology, Jacksonville, FL Prithipal S. Sethi, MD, Golden State Urology, Sacramento, CA Hunter S. Robinson, MD, Geisinger Medical Center, Department of Urology, Danville, PA Keavash D. Assani, MD, Department of Urology, Vanderbilt University Medical Center; Nashville, TN Vijay Rings, MD, Department of Urology, Vanderbilt University Medical Center; Nashville, TN Janene Pierce, BS, Department of Urology, Vanderbilt University Medical Center; Nashville, TN Kristen R. Scarpato, MD, MPH, Department of Urology, Vanderbilt University Medical Center; Nashville, TN Kelvin A. Moses, MD, PhD, Department of Urology, Vanderbilt University Medical Center; Nashville, TN Daniel A. Barocas, MD, MPH, Department of Urology, Vanderbilt University Medical Center; Vanderbilt-Ingram Cancer Center, Nashville, TN Sam S. Ch

FAQs

What does the urine test predict in active surveillance patients?

The urine test is designed to predict Grade Group upgrading in patients with prostate cancer who are managed on active surveillance.

How is the study strengthened by using multisite validation?

Multisite validation assesses whether the test’s predictive performance generalizes across different sites rather than being limited to a single cohort.

How does the urine test relate to MRI in the study?

The study compares the urine test’s results with MRI to evaluate how the two approaches align and differ for predicting upgrading.

Sep 23, 2026

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