Stability of a 17-Gene Genomic Prostate Score in Serial Testing of Men on Active Surveillance for Early Stage Prostate Cancer

Genomic testing may improve risk stratification in men with prostate cancer managed by active surveillance. We aimed to characterize the stability and usefulness of serial genomic test scores in men undergoing serial biopsies during active surveillance. We compiled clinical and disease characteristi...

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Bibliographic Details
Published in:The Journal of urology Vol. 202; no. 4; p. 696
Main Authors: Cedars, Benjamin E, Washington, 3rd, Samuel L, Cowan, Janet E, Leapman, Michael, Tenggara, Imelda, Chan, June M, Cooperberg, Matthew R, Carroll, Peter R
Format: Journal Article
Language:English
Published: United States 01.10.2019
Subjects:
Aged
Biomarkers, Tumor - genetics
Biopsy
Disease Progression
Follow-Up Studies
Genetic Testing - methods
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prostate - pathology
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - genetics
Prostatic Neoplasms - pathology
Retrospective Studies
Risk Assessment - methods
Watchful Waiting - methods
biopsy
molecular diagnostic techniques
gene expression
watchful waiting
prostatic neoplasms
ISSN:1527-3792, 1527-3792
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Summary:Genomic testing may improve risk stratification in men with prostate cancer managed by active surveillance. We aimed to characterize the stability and usefulness of serial genomic test scores in men undergoing serial biopsies during active surveillance. We compiled clinical and disease characteristics of men on active surveillance using an institutional Urologic Outcomes Database. We included patients initially diagnosed with Gleason 3 + 3 prostate cancer who elected active surveillance and received 2, 17-gene GPS (Genomic Prostate Score) results. We examined the association of GPS results and Gleason grade reclassification (Gleason 3 + 4 or greater) with definitive treatment using multivariable Cox proportional hazards regression models. We identified 111 men who underwent serial genomic testing. There were 49 grade reclassification events (44%) at a median followup of 64 months. The mean ± SD GPS change between the first and second biopsies was 2.1 ± 10.3. The GPS at first biopsy (per 5 units HR 1.04, 95% CI 1.00-1.07, p=0.03) was associated with an upgrade at second biopsy, although the second GPS was not (HR 1.02, 95% CI 0.99-1.05, p=0.13). The first and second GPSs (HR 1.09, 95% CI 1.04-1.14 and HR 1.09, 95% CI 1.04-1.14, each p <0.01) were associated with active treatment. The GPS undergoes small changes with time. Absolute GPS results at the first and second biopsies were associated with Gleason upgrading and transition from active surveillance to active treatment.
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ISSN:1527-3792
1527-3792
DOI:10.1097/JU.0000000000000271