Prostate cancer: 17-gene GPS fails to predict adverse pathology in active surveillance

  • Lin DW & al.
  • J Clin Oncol
  • 4 Mar 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.>

Limitations

  • Small sample size.