Mp25-12 Utilizing the Genomic Prostate Score (Gps) as a Prognostic Biomarker in Patients With Localized Prostate Cancer Undergoing Focal Therapy

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-12 UTILIZING THE GENOMIC PROSTATE SCORE (GPS) AS A PROGNOSTIC BIOMARKER IN PATIENTS WITH LOCALIZED PROSTATE CANCER UNDERGOING FOCAL THERAPY Sriram Deivasigamani, Srinath Kotamarti, Mahdi Mottaghi, Eric S. Adams, Zoe Michael, Joao Paulo Zambon, Anu Pondichetty, Thuy Can, and Thomas J. Polascik Sriram DeivasigamaniSriram Deivasigamani , Srinath KotamartiSrinath Kotamarti , Mahdi MottaghiMahdi Mottaghi , Eric S. AdamsEric S. Adams , Zoe MichaelZoe Michael , Joao Paulo ZambonJoao Paulo Zambon , Anu PondichettyAnu Pondichetty , Thuy CanThuy Can , and Thomas J. PolascikThomas J. Polascik View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For ideal candidates, focal therapy (FT) allows for the treatment of specific lesions while preserving uninvolved regions of the gland, offering the possibility of enhanced postoperative functional outcomes with good oncological control. The ability to risk stratify and predict recurrence post FT remains unclear. Genomic testing (Genomic Prostate Score) has proven to accurately stratify PCa risk for adverse outcomes before radical approaches. The genomic test has not been evaluated in the setting of FT for localized PCa and we sought to first report the potential utility of the GPS in the setting of FT. METHODS: This is a retrospective review of a prospectively maintained database of prostate cancer patients undergoing prostate FT at Duke between 2005 and 2020. The study included men with localized PCa, pre-operative diagnostic biopsy tissue availability, and a minimum follow-up of 1-year. The primary endpoint was to determine the ability of the GPS test performed in the pre-operative tissue sample to predict treatment failure defined as requirement of salvage therapy including radical prostatectomy, radiation therapy, repeat ablation, systemic therapy and development of distant metastasis, and cancer-specific death. The secondary outcome was to assess whether the GPS test can predict >GG2 biopsy recurrence following ablation. RESULTS: A total of 81 patients met the inclusion criteria. The median follow-up was 48 months (interquartile range (IQR), 35-98). The median age, preoperative PSA, and PSA density were 74 yrs (IQR, 68-77), 7.4 ng/ml (IQR, 5.5-10), and 0.19 ng/ml/ml (0.14-0.22). Of 81 patients, 55 (68%) and 7 (9%) had D'Amico intermediate and high-risk disease. The median GPS score was 30 (IQR, 24-40) and 21/81 (26%) had a GPS result >40. Treatment failure and >GG2 biopsy recurrence were observed in 15/81 (19%) and 10/81 (12%), respectively. GPS was >40 in 8/15 (53%) and 7/10 (70%) of patients with TF and BR, respectively. On univariable analysis, GPS were significantly associated with TF (Hazard ratio [HR], 1.07, 95% confidence interval [CI], 1.02-1.12), p<0.01, and BR (HR, 1.09, 95% CI, 1.03-1.15, p=0.08). Men with GPS of 40-100 were found to be significantly associated with TF (HR, 4.19, 95% CI, 1.26-13.89, p=0.01) and BR (HR, 9.5, 95% CI, 2.18-41.46, p=0.03), respectively. CONCLUSIONS: Among men treated with focal ablation for localized prostate cancer, the GPS assay appears to be a prognostic indicator of treatment failure and biopsy recurrence. Further studies with large sample sizes are required to validate this findings. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e409 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sriram Deivasigamani More articles by this author Srinath Kotamarti More articles by this author Mahdi Mottaghi More articles by this author Eric S. Adams More articles by this author Zoe Michael More articles by this author Joao Paulo Zambon More articles by this author Anu Pondichetty More articles by this author Thuy Can More articles by this author Thomas J. Polascik More articles by this author Expand All Advertisement PDF downloadLoading ...