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ASCO 2026 | Evaluating microRNA 371a-3p performance in testicular cancer surveillance

Lucia Nappi, MD, University of British Columbia, Vancouver, Canada, discusses the results of an interim analysis on the performance of a microRNA 371a-3p (miR371) test in the SWOG S1823 trial (NCT04435756), noting that the false positivity rate was low, but false negativity was higher in detecting relapse, which may be related to the association between microRNA 371 expression and tumor burden. Sensitivity increased with the stage of relapse and methodological aspects, such as the type of blood collection tube used, can be improved to enhance sensitivity. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

microRNA 371 false positivity in this first interim analysis on 224 patients was very low. Only 10 samples among the control patients had a false positive result. So that was a 6% false positivity. That led to the very high specificity of the test. So it’s not really of a concern. And we did exclude the hemolyzed samples as a quality control for our analysis, which I think did decrease the false positivity rate...

microRNA 371 false positivity in this first interim analysis on 224 patients was very low. Only 10 samples among the control patients had a false positive result. So that was a 6% false positivity. That led to the very high specificity of the test. So it’s not really of a concern. And we did exclude the hemolyzed samples as a quality control for our analysis, which I think did decrease the false positivity rate. False negativity was more of a concern. As I mentioned, sensitivity was around 64% in the patients who had the samples detected of the relapse. And this is most likely related to the known association between the microRNA 371 expression and tumor burden because the sensitivity did increase with the stage of the relapse. There are certain methodology aspects that we can improve to improve sensitivity. For example, the clinical study that was presented by the ANZAP group used not serum tube to collect the blood, but they used EDTA tubes. So maybe that could have an impact on the sensitivity. I’m not sure. And for the sub-histology group, we know that teratoma, which is a subtype of non-seminoma germ cell tumors, does not express microRNA-71. So in the future integration of microRNA-71 in our clinical practice, we have to take that into account. So if we do have a non-seminoma patient with teratoma, if there is a clinical suspect of growing teratoma syndrome and the microRNA is always negative, obviously that is extremely suspicious for a teratoma.

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