URINE BIOMARKERS
A method for detecting biomarkers of prostate cancer or other medical condition of the prostate based on the use of microvesicles obtained from urine samples, and the nucleic acids present in the microvesicles. The method disclosed herein are advantageous in that they may be used to support diagnosis, prognosis, monitoring, or therapy selection in lieu of or in conjunction with traditional biopsy-based diagnostics and do not require a digital rectal examination or prostate massage prior to urine sample collection.
1 .- 26 . (canceled)
27 . A method for diagnosis, prognosis or monitoring for a medical condition of the prostate gland in a subject, comprising the steps of:
(a) processing a urine sample from the subject to remove cells and cell debris while retaining a microvesicle fraction from the urine sample;
(b) extracting one or more nucleic acids from the microvesicle fraction;
(c) detecting a level of expression for a biomarker associated with a medical condition of the prostate gland in the extracted nucleic acids, wherein the biomarker is one or more isoforms of ERG, AMACR, TMPRSS2-ERG, PCA3 or a combination thereof, and detecting a level of expression of a reference gene; and
(d) determining a normalized, relative expression level of the biomarker, wherein the relative expression level of the biomarker is a ratio between the level of biomarker expression to the level of reference gene expression,
wherein the subject is identified as suffering from, or being at an increased risk for, the medical condition of the prostate gland when the relative expression level of the biomarker is greater than a cutoff level of biomarker expression.
28 . The method of claim 27 , wherein the one or more isoforms are one or more of ERG is selected from the group consisting of ERG1, ERG2, ERG3, ERG4, ERG5, ERG6, ERG7, ERG8, or ERG9.
29 . The method of claim 27 , wherein the medical condition is prostate cancer.
30 . The method of claim 29 , wherein the prostate cancer is castration resistant prostate cancer.
31 . The method of claim 27 , wherein the biomarker is RNA.
32 . The method of claim 27 , wherein the reference gene is GAPDH, KLK3 or a combination.
33 . The method of claim 27 , wherein step (a) comprises a step of filtration concentration.
34 . The method of claim 27 , wherein the cutoff level of biomarker expression is a score based on a collective level of biomarker expression in a control group of subjects that are not suffering from the medical condition of the prostate.
35 . A method for treating a medical condition of the prostate gland in a subject, the method comprising the steps of:
(a) processing the urine sample to remove cells and cell debris while retaining a microvesicle fraction from the urine sample;
(b) extracting one or more nucleic acids from the microvesicle fraction;
(c) detecting a level of expression for a biomarker associated with a medical condition of the prostate gland in the extracted nucleic acids, wherein the biomarker is one or more isoforms of ERG, AMACR, TMPRSS2-ERG, PCA3 or a combination thereof, and detecting a level of expression of a reference gene; and
(d) determining a normalized, relative expression level of the biomarker, wherein the relative expression level of the biomarker is a ratio between the level of biomarker expression to the level of reference gene expression,
(e) administering at least one therapy to the subject when the relative expression level of the biomarker is greater than a cutoff level of biomarker expression.
36 . The method of claim 35 , wherein the at least one therapy is selected from the group consisting of localized radiation therapy, chemotherapy, adjuvant therapy, cryotherapy, ablation therapy and an anti-cancer agent.
37 . The method of claim 36 , wherein the anti-cancer agent is selected from the group consisting of abiraterone, MDV3100, sipuleucel-T (Provenge) and cabazitaxel.
38 . The method of claim 35 , wherein the medical condition is prostate cancer.
39 . The method of claim 38 , wherein the prostate cancer is castration resistant prostate cancer.
40 . The method of claim 35 , wherein the biomarker is RNA.
41 . The method of claim 35 , wherein the reference gene is GAPDH, KLK3 or a combination.
42 . The method of claim 35 , wherein step (a) comprises a step of filtration concentration.
43 . The method of claim 35 , wherein the cutoff level of biomarker expression is a score based on a collective level of biomarker expression in a control group of subjects that are not suffering from the medical condition of the prostate.
44 . A kit comprising a plurality of nucleic acid molecules,
wherein at least one nucleic acid molecule in the plurality comprises the nucleic acid sequence put forth in SEQ ID NO: 1,
wherein at least one nucleic acid molecule in the plurality comprises the nucleic acid sequence put forth in SEQ ID NO: 2, and
wherein at least one nucleic acid molecule in the plurality comprises the nucleic acid sequence put forth in SEQ ID NO: 3.