- Biopsy-based 17-gene Genomic Prostate Score (GPS) was significantly associated with adverse pathology (AP) after adjusting for diagnostic Gleason grade (GG), but not when adjusted for GG and PSA density both.
- GPS was not associated with upgrading in subsequent biopsies during active surveillance, but PSA density and positive biopsy cores remained significantly associated with upgrading.
Why this matters
- GPS test predicts AP in patients with low-risk prostate cancer treated with immediate surgery.
- 432 patients from Canary PASS study were evaluated.
- The primary endpoint was AP (GG, ≥3) in men who underwent surgery after initial surveillance.
- Funding: Canary Foundation; National Institutes of Health; others.
- Median follow-up: 4.6 years.
- 39% of patients upgraded at a surveillance biopsy.
- Median time from diagnosis to surgery was 2.1 years.
- GPS was significantly associated with AP when adjusted for diagnostic GG (adjusted [a]HRper 5 GPS units, 1.18; P=.030), but not when adjusted for both PSA density and diagnostic GG (aHR, 1.17; P=.066).
- No association was observed between GPS and subsequent biopsy upgrade (aHR, 0.97; P=.48).
- Log2 PSA density (aHR, 1.44; P<.001 and percentage of positive cores p were independently associated with upgrade.>
- Small sample size.