5106 Background: Current trials use prostate-specific antigen (PSA) response of ≤0.2 ng/mL at 6-12 months as a prognostic marker and identify patients for intermittent therapy. Clinico-genomic assessment can increase prognostic accuracy and patient selection for intermittent therapy, which would improve quality of life and decrease adverse events associated with mHSPC combination therapies without impacting survival. Methods: Retrospective study of veterans diagnosed with mHSPC between 2018-2024. PSA response at 6-12 months and volume of disease were determined. DNA alterations were classified by Somatic Tumor Risk Assessment for Overall Survival-Prostate (STRATOS-P) genomic system, a validated method of risk stratification. PSA response was grouped into ≤0.2, >0.2-0.2 - 2 210 1.60 1.25-2.04 PSA Response# >2 - <10 131 2.98 2.30-3.84 10+ 87 5.64 4.26-7.47 *STRATOS-P genomic risk favorable is referent, n=335. #PSA Response ≤0.2 is referent, n=509.
Schoen et al. (Wed,) studied this question.