ORLANDO, FL USA (UroToday.com) - In patients with high-risk prostate cancer (PC), radiation therapy (RT) is frequently offered following prostatectomy, but response rates vary. The authors assessed the ability of the genomic classifier (GC) (DecipherTM) to predict clinical progression in men following post-RP RT. Approximately 200 patients from a multi-institutional cohort (Thomas Jefferson University and Mayo clinic), treated with post-RP RT, were evaluated to assess the ability of GC scores to predict BCR, clinical metastasis, and distant metastasis. Among the Mayo cohort, the AUC for GC was 0.78 for clinical metastasis. Among the Jefferson cohort, use of GC score improved AUC to 0.75 and 0.77 for BCR and distant metastasis, respectively.
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In both cohorts, GC was the most significant predictor of clinical progression after RT. Following multivariable adjustment for GC, CAPRA-S, and concurrent hormone therapy, patients with high GC had a 7-fold increased risk of BCR. A similar trend for clinical metastasis was observed in the Mayo cohort, but statistical significance was not reached. Incorporation of GC score in patient post-RP RT predicted treatment failure and improved risk stratification. Increased GC score following post-RP RT was significantly associated with higher risk for clinical progression. The use of GC score to influence and sequence systemic therapy requires further investigation.
Presented by Edouard J. Trabulsi, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Thomas Jefferson University Hospitals, Philadelphia, PA USA
Written by Jeffrey J. Tomaszewski, MD, medical writer for UroToday.com
AUA 2014, #AUA14, radiation therapy (RT), genomic classifier (GC)