AUA 2017: Prognostic Utility of Biopsy-Derived Cell Cycle Progression Score in Patients with NCCN Low-Risk Prostate Cancer Undergoing Radical Prostatectomy: Implications for Treatment Guidance

Boston, MA (UroToday.com) Myriad Genetics, Inc. developed Prolaris®, a 46-gene RNA expression test that measures genomic risk in disease-specific mortality for patients with prostate cancer. Until now, available data has been limited in predicting outcomes of African Americans. This recent retrospective study of localized adenocarcinoma patients evaluated the cell cycle progression (CCP) score using diagnostic biopsies of a large cohort analyzed for African Americans (AA) and for Non-African Americans (NAA).The cohort was men treated during 2006-2011. The objective was to predict metastatic disease.

Samples were analyzed for expression levels of 31 genes and 15 householder genes. The CCP score was calculated as the unweighted average of the CCP gene expression normalized by the household gene expression. A combined clinical risk (CCR) score was calculated as the linear combination of CCP and University of California at San Francisco’s Prostate Cancer Risk Assessment (CAPRA) score (.57 CCP + .37 CAPRA).

Progression to metastatic disease was confirmed by imaging and was evaluated for the entire cohort (39 events, 5.1%) and in the subset that received definitive therapy. Time to metastatic disease was measured in days from date of diagnosis. Outcome data was censored at 10 years. Of the 969 clinically eligible cases, 767 had passing CCP scores and information to calculate CAPRA score. 36.6 % of men were AA. 84% of men received definitive treatment.

Median age at diagnosis was 66 for NAA vs. 63 for AA. Median PSA was 5.8 for NAA vs. 6.9 for AA.

The study's conclusions were:

1) Results revealed that the CCP score was a significant predictor of metastatic disease in this large cohort that included a substantial % AA. This is consistent with previous reports.

2) In this study, there is no significant difference of an interaction between the CCP score and either race or treatment (CCP Hazard Ratio, was not significantly different).

3) After evaluation of all molecular and clinicopathologic information, there is no evidence that AA men have more aggressive disease than NAA men. This finding is contrary to expectation.

4) The study re-validates that CCP score is a significant and independent tool to forecast prostate cancer outcomes in men irrespective of race, risk classification or type of treatment.

Presented By: Stephen Bardot, MD Ochsner Clinic

Authors: José Cadilhe*, Viana do Castelo, Portugal

Written By: John Fortin, Retired Healthcare Actuary, Fellow in the Society of Actuaries, and Patient-Advocate; and Henry Oat, Clinical Trial Patient Coordinator at Desert Medical Imaging, Prostate Cancer Support Group Leader, and Patient-Advocate

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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