PASCUAL (Prostate Assay Specific Clinical Utility at Launch) Study
PASCUAL (Prostate Assay Specific Clinical Utility at Launch) Study
The main hypothesis of this study is to demonstrate that the use of the ConfirmMDx for
 Prostate Cancer test in previously biopsied patients improves urologists' patient management
 by reducing unnecessary repeat biopsies, attendant procedure costs, and potential adverse
 events in men being considered for a repeat procedure.
The results of the study will reveal the clinical utility of this test by analyzing the
 physicians' use of negative or positive assays compared to patients managed using SOC methods
 without assay findings. The repeat biopsy rate at 12 months from study entry will be used for
 the primary endpoint analysis. All patients will be followed for 24 months from the date of
 the previous negative biopsy to evaluate an extended period of observation to track repeat
 biopsies and cancer detection.

 The primary objective of this study is to demonstrate a lower repeat biopsy rate by using the
 negative results of ConfirmMDx for Prostate Cancer in practice rather than current SOC. All
 patients will have the tissue from their previous negative biopsy tested with the assay. Only
 data from Cases (informed of ConfirmMDx assay results) and Controls (blinded of the
 ConfirmMDx assay result) patients with negative test results will be used for the primary
 objective.
Inclusion Criteria:

 -  Males aged 40 to 75 years old* that underwent a previous cancer-negative prostate
 biopsy within 15 months and being considered for a repeat biopsy due to persistent or
 elevated cancer-risk factors

 -  The previous negative prostate biopsy must have collected a minimum of 8 tissue cores
 and remaining FFPE tissue from all cores should be available for testing

 -  Minimum tissue volume criteria of 20 microns of prostate biopsy core tissue should be
 available (40 microns preferable)

 -  The presence of HGPIN (high-grade prostatic intraepithelial neoplasia), PIA
 (proliferative inflammatory atrophy), or glandular inflammation reported in the first
 biopsy histopathology report is acceptable for entry.

 Exclusion Criteria:

 -  Prior diagnosis of prostate cancer or cellular atypia suspicious for cancer (ASAP) in
 a previous biopsy histology report.

 -  Patients being managed by Active Surveillance for low stage prostate cancer

 -  Men greater than 75 years old (generally not considered for repeat biopsy)

 -  Most recent biopsy was a saturation biopsy (> 24 tissue cores).

 -  Tissue extracted using transurethral resection of the prostate (TURP) procedures
 rather than standard patterned biopsy core extraction.

 -  Subjects who had been previously tested with ConfirmMDx.