The 17-Gene Genomic Prostate ScoreĀ® Test is Prognostic for Outcomes after Primary External Beam Radiation Therapy in Men with Clinically Localized Prostate Cancer.

The Oncotype DX Genomic Prostate Score® (GPS™) assay has been validated as a strong prognostic indicator of adverse pathology, biochemical recurrence, distant metastasis (DM), and prostate cancer (PCa)-related death (PCD) in men with localized PCa after radical prostatectomy. However, it has yet to be tested in men undergoing external beam radiation therapy (EBRT), for whom assessing PCa progression risk could inform decisions on treatment intensity. We analyzed whether GPS results are associated with time to biochemical failure (BCF), DM, and PCD after EBRT in men with localized PCa and whether the association is modified by race.

We conducted a retrospective study of men with localized PCa treated with EBRT at the [ANONYMIZED FOR REVIEW] from 2000 to 2016. Study endpoints were time to BCF per the Phoenix criteria, DM, and PCD. The association of GPS results, per 20-unit increase or dichotomous variable (0-40 versus 41-100), was evaluated with each endpoint using univariable and multivariable Cox proportional hazards models. Results were then stratified by race.

A total of 238 patients (69% Black) met eligibility criteria. Median follow-up for patients who did not experience BCF was 7.6 years. GPS results per 20-unit increase were significantly associated with BCF (hazard ratio (HR) 3.62; 95% CI 2.59, 5.02), DM (HR 4.48; 2.75, 7.38), and PCD (HR 5.36; 3.06, 9.76) in univariable analysis. GPS results remained significant in multivariable models adjusted for baseline clinical and pathological factors, with HRs similar to the univariable analysis. There was no significant interaction between the GPS assay and race (p=0.923). HRs for BCF were similar in Black men (3.88; 2.40, 6.24) versus non-Black men (4.01; 2.42, 6.45).

Among men treated with EBRT, the GPS assay is a strong, independent prognostic indicator of time to BCF, DM and PCD, and performs similarly in Black and non-Black men.

International journal of radiation oncology, biology, physics. 2022 Jul 17 [Epub ahead of print]

Jessica L Janes, Matthew J Boyer, John Bennett, Vanessa M Thomas, Amanda M De Hoedt, David K Edwards V, Purva K Singla, John Abran, Tamer Aboushwareb, Joseph K Salama, Stephen J Freedland

Research Service, Durham VA Health Care System, Durham, NC. Electronic address: ., Department of Radiation Oncology, Duke University Medical Center, Durham, NC; Radiation Oncology Service, Durham VA Health Care System, Durham, NC., Exact Sciences Corporation, Redwood City, CA. Electronic address: ., Research Service, Durham VA Health Care System, Durham, NC., Exact Sciences Corporation, Redwood City, CA., Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA; Department of Surgery, Durham VA Health Care System, Durham, NC. Electronic address: .

email news signup