What is “MCM”?

MCM stands for Mini-Chromosome Maintenance protein - an antibody used for detecting cell turnover including in malignancy.

Will MCM testing replace cystoscopy?

In the short-term, MCM testing will not replace cystoscopy - but in the future, with the development of the test, and its possible introduction into medical clinics as a routine procedure for patients presenting with possible bladder cancer, it may be used either in parallel with cystoscopy or possibly even replace it altogether.

How reliable is this MCM test as a diagnostic aid?

MCM may be a helpful addition to the diagnosis of bladder cancer.  Early indications suggest that it has got a high degree of sensitivity and a good degree of specificity, and can successfully run in parallel to cystoscopy as a diagnostic aid to bladder cancer.  It is better than routine cytology in making this diagnosis.

How reliable is this MCM test as a screening tool?

In due course, it may well be that MCM will take on the role of a screening tool for patients with possible bladder cancer, and may become a requirement prior to cystoscopy. 

When will the MCM test be available for bladder cancer?

Current experience (2009) suggests that further development of MCM from the research phase to routine clinical use may take up to three or four years.

Will a medical General Practitioner (GP) be able to carry out this test in the surgery?

This is not envisaged at present, but in the future it may well be a feasible option for the GP either in his own practice or through a group practice scheme in Primary Care.

Does the MCM test involve special equipment in the laboratory?

All the equipment apart from the MCM antibody itself is routine in most modern accredited laboratories.  The preparation of liquid-based cytology slides is now routine both in the EEC and in the USA, and is a necessary precursor to the antibody label.

Who invented the test?

This MCM antibody was derived from experimental work hosted by the Cancer Research UK charity in the UK, and derived from the MRC Laboratories at Addenbrookes Hospital in Cambridge.  It has a strong pedigree of research and has already been applied to the early detection of cervical cancer.

How many patients have had the test so far?

More than 400 patients in two centres have already had the test in Aberdeen Royal Infirmary and Addenbrookes Hospital, Cambridge. 

How many hospitals are conducting the test?

Currently two hospitals are actively involved in undertaking clinical work with MCM antibody, but a number of other UK hospitals are in the process of consideration.

Is the MCM test very expensive?

This test is substantially cheaper than the current process of investigating patients with possible bladder cancer.  It is seen as a real way forward for patients with this possible disease.

Does this test have any application to any other cancers apart from bladder cancer?

MCM antibody has a real application in cervical cancer and a major US-based diagnostic company is already developing this as a screening test for cervical cancer.  Its success rate is high and its false positive rate is low.

Could MCM be used as a test in the diagnosis of prostate cancer?

Again, this is an opportunity being explored by Cytosystems.  We already have evidence that we can match the laboratory test for prostate cancer by using a urine test for prostate cancer cells and MCM antibody.  The initial data looks very promising, based (early 2009) on tests with more than 80 patients.

What role would MCM have in prostate cancer, either with or without prostate-specific antigen (PSA), the blood test?

Unfortunately, PSA as a diagnostic test for prostate cancer has a very poor diagnostic value.  The outcome can give false positive results in up to 60% of all patients.  The initial evidence for MCM as an antibody is that it has a very high diagnostic accuracy with a low false positive rate and therefore looks, even in these early stages, promising.

Could MCM replace PSA as a screening test?

The initial indications here suggest that MCM as a simple urine test could act as an additional diagnostic screening test for those patients who present to the clinic with high PSA values.  Further clinical trial work is required in order to define its appropriate place with respect to PSA.  The key issue here is that MCM antibody as a test may obviate the need for multiple prostate biopsies.