Open Access

ARTICLE

How I Use It: The Exosome Diagnostics (EPI) prostate cancer biomarker utility in urology and primary care

Judd W. Moul¹, Grannum R. Sant²

1 Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina, USA
2 Department of Urology, Tufts University School of Medicine, Boston, Massachusetts, USA
Address correspondence to Dr. Judd W. Moul, Division of Urologic Surgery, Duke Cancer Institute, DUMC 3707-Room 1562 Duke South, Durham, NC 27710 USA

Canadian Journal of Urology 2022, 29(4), 11224-11230.

Abstract

Prostate-specific antigen (PSA) screening remains the mainstay for early detection of prostate cancer. Although PSA is a nonspecific prostate cancer biomarker, its specificity for high grade prostate cancer can be enhanced by pre-biopsy liquid biomarkers including the Exosome Dx Prostate IntelliScore (EPI) test.
EPI is a stand-alone urine genomic test that measures 3 exosome-derived gene expression signatures without the need for digital rectal examination (DRE) or inclusion of standard of care parameters in the test algorithm. EPI has broad clinical utility as a risk stratification tool for clinically significant high grade prostate cancer in men considering diagnostic prostate biopsy (MRI-targeted and systematic biopsy).
During the COVID-19 pandemic, the EPI At-Home Collection Kit was introduced and quickly became an important component of tele-urology. The EPI test has emerged as a prioritization tool for primary care referral to urologists and for prostate biopsy scheduling.
EPI provides an objective and actionable genomic risk assessment tool for high grade prostate cancer and is a critical part of the informed decision-making regarding biopsy (targeted, systematic or both) in both urology and primary care practices.

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