At EAU 2026 the studies on urinary biomarkers for prostate cancer

The European Congress of Urology (EAU) is, every year, the most important scientific reference point for those involved in urology.

An event that attracts thousands of specialists, researchers, and clinicians from around the world, it represents a place where the most significant advances in the discipline are shared and future directions for clinical practice are defined.
This year, in London, the research group of Prof. Francesco Porpiglia of the San Luigi Gonzaga Hospital in Orbassano will bring two selected abstracts, both dedicated to the use of urinary biomarkers to improve the diagnosis and risk stratification of prostate cancer.

They will be presented by Dr. Sabrina De Cillis, a urologist at San Luigi and a member of the team that has been working on these topics for years with scientific rigor and great clinical vision.
We at NIB biotec are proud to have contributed to these projects by providing support for the development and validation of the tests, continuing our long-standing collaboration with the Urology Department.

1. The PSA paradox revealed by urine: less PSA, more risk

SESSION: Prostate cancer: Imaging, biopsy and targeted treatments

TITLE: Unveiling the Paradox: lower urinary PSA levels as a stronger indicator of Prostate Cancer risk compared to blood PSA elevation

A surprising, almost counter-current concept that is emerging with ever greater evidence: urinary PSA (uPSA) may be a more reliable indicator of cancer risk than the classic blood PSA.

Blood PSA has been a cornerstone of diagnostic workups for decades. When it increases, it immediately suggests possible prostate cancer. However, in everyday clinical practice, most PSA elevations are due to prostatitis, benign enlargements, or other non-cancerous conditions.

And the paradox lies right here:
Prostate cancer, when it develops, reduces the ability of cells to produce PSA.
In fact, inside the prostate, a healthy gland contains a lot of PSA, while tumor tissue contains less and less.

Why then does PSA increase in the blood?
Because the tumor destroys the architecture of the gland and the PSA – although produced in smaller quantities – leaks more easily into the bloodstream.

Urine, on the other hand, reflects exactly what is happening inside the prostate.

The results of the study

The study conducted at San Luigi on 200 patients showed that:

• urinary PSA decreases markedly as the severity of the tumor increases;
• distinguishes healthy subjects from sick ones better than traditional parameters;
• shows a superior diagnostic performance to blood PSA (AUC 0.72 vs. 0.50);
• integrated with the MRI results it reaches an AUC of 0.82, very close to that of the most advanced tests available today.

A result that suggests that uPSA could become a new non-invasive screening tool, simple, biologically consistent and more accurate in selecting men truly at risk.

2. A rapid test based on PSA and Zinc: towards a new era of "proximity" screening

Session: Advances in prostate cancer management

Title: A Rapid Dual-Urine Biomarker Test for Accurate Prostate Cancer Risk Stratification

An even more immediate tool for clinical practice: a rapid urine test that combines PSA and zinc, designed to be used anywhere – in the hospital, in the doctor's office, and even in the family doctor's office.

The idea arises from two consolidated findings:

• a healthy prostate releases high levels of PSA into the urine;
• Tumor cells progressively lose the ability to retain zinc, with a sharp drop in its levels.

The test uses both signals and assigns a simple score (0–2) that indicates whether the biomarkers are normal, altered, or both altered.

What emerges from the study

In the prospective study of men with indication for prostate biopsy:

• 100% of ISUP 4–5 tumors had a score of 1 or 2;
• almost half of the biopsy-negative subjects had a score of 0;
• integrating the score with PSA, DRE and MRI results in a very effective triage algorithm;
• Most importantly: No high-risk patient is misclassified as low-risk.

A result that opens up very interesting prospects for a faster, less invasive and more accessible diagnosis.
This type of test can reduce the number of unnecessary biopsies, facilitate screening in areas with less access to advanced diagnostics, improve patient adherence thanks to its simplicity and low cost, and enhance the activity of community clinics.

Bringing innovation to the heart of international urology

Attending EAU 2026 is not just a scientific achievement: it's an opportunity to share with the international community the results of research that truly aims to improve patients' lives.

For us at NIB biotec, who supported these studies by accompanying them throughout the technical and analytical phases, it is a source of great pride to be able to contribute to bringing Italian innovation to such a prestigious stage.

London will be the ideal place to publicize these findings and initiate new collaborations, with a single goal: to make prostate cancer diagnosis more accurate, less invasive, and more accessible to all.