Introducing Prompt® Prostate Genetic Score, a simple and highly validated test that evaluates a man’s genetic predisposition to developing prostate cancer. Prompt was developed by urologists frustrated with the lack of information used to make prostate cancer screening decisions. Prompt provides patients with a personalized assessment of their baseline risk of prostate cancer so that, together with their doctors, better, more informed screening decisions can be made.

Despite being curable with early detection, prostate cancer remains the second leading cause of cancer deaths in men.1 Most men who die of prostate cancer have never been screened.2 Although screening is the key to early detection and cure, data from large clinical trials suggest that screening is not for everyone. As a result, several groups have recommended against screening, which has been associated with a decrease in new diagnoses and a rise in the number of men with more advanced, often incurable disease.3, 4

The current screening tools, digital rectal exam and PSA testing, are important for some men, but screening may not be necessary for everyone and could in fact be harmful to some. False positives can result in unnecessary and potentially dangerous biopsies, while the diagnosis of clinically indolent disease can lead to damaging side effects.

Although screening in men with a family history is important, relying on family history alone may not be enough.6 Ideally, we would have an objective, stable assessment of a man’s lifetime risk of developing prostate cancer so that an informed decision can be made about whether and how intensively they want to be screened.

Prompt is designed to provide the knowledge of baseline prostate cancer risk, which is critical to an informed conversation regarding the risks and benefits of prostate cancer screening.

Risk Stratification Using Family History

The risk of prostate cancer in the placebo arm of the REDUCE clinical trial was 24%. By adding family history, those men with a negative history, which made up 87% of the study population, had a 23% risk of prostate cancer. Those with a positive family history had a 33% risk of prostate cancer. By adding family history, the risk is only bifurcated into positive and negative.

Issues with Family History

  1. Only helpful if positive
  2. Dependent on number and age of male family members
  3. Changes with time
  4. Subject to recall bias

Risk Stratification Using Prompt

Prompt stratifies the risk of the entire population. Instead of bifurcating risk into 23% for negative family history and 33% for positive family history, we get a complete and personalized risk assessment of the entire population, regardless of family history.

Given the high risk nature of the REDUCE study population, the average risk of all men in the study was 24%.

Possible Risk Adapted Screening Algorithm

Rather than screening all men solely based on family history, Prompt offers a stable, objective measure, including family history, of lifetime risk of prostate cancer. This allows clinicians to focus screening efforts on those men who are at greatest risk and better informs patients of their individualized risk.

This algorithm is only hypothetical and has not been validated.

Process_Visit

Step 1

Physician discusses genetic screening with patient

Process_OrderTest

Step 2

Patient orders test through Stratify Genomics

Process_Sample

Step 3

Patient opens Prompt kit and swabs inside of cheek

Process_Lab

Step 4

Patient sends sample to CLIA Lab and results are processed

Process_Report

Step 5

CLIA Lab sends results to physician

Process_Meet

Step 6

Physician follows up with patient to review score and discuss screening options

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA: a cancer journal for clinicians. 2018;68(1):7-30.
  2. Fontenot PA, Jr., Nehra A, Parker W, Wyre H, Mirza M, Duchene DA, et al. Metastatic prostate cancer in the modern era of PSA screening. International braz j urol : official journal of the Brazilian Society of Urology. 2017;43(3):416-21.
  3. Gaylis FD, Choi J, Kader AK. Trends in Metastatic Breast and Prostate Cancer. The New England journal of medicine. 2016;374(6):594-5.
  4. Negoita S, Feuer EJ, Mariotto A, Cronin KA, Petkov VI, Hussey SK, et al. Annual Report to the Nation on the Status of Cancer, part II: Recent changes in prostate cancer trends and disease characteristics. Cancer. 2018;124(13):2801-14.
  5. Chen H, Liu X, Brendler CB, Ankerst DP, Leach RJ, Goodman PJ, et al. Adding genetic risk score to family history identifies twice as many high-risk men for prostate cancer: Results from the prostate cancer prevention trial. The Prostate. 2016;76(12):1120-9.
  6. Liss MA, Chen H, Hemal S, Krane S, Kane CJ, Xu J, et al. Impact of family history on prostate cancer mortality in white men undergoing prostate specific antigen based screening. J Urol. 2015;193(1):75-9.
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