Mp41-12 Assessing Molecular Heterogeneity of Prostate Cancer Biopsy Sampling: Insights From the Mast Trial

You have accessJournal of UrologyProstate Cancer: Markers I (MP41)1 May 2024MP41-12 ASSESSING MOLECULAR HETEROGENEITY OF PROSTATE CANCER BIOPSY SAMPLING: INSIGHTS FROM THE MAST TRIAL Tarek Ajami, Hui Yu, Yuval Avda, Nachiketh Soodana-Prakash, Sandra Gaston, Alan Pollack, Brandon Mahal, Radka Stoyanova, Aleksandr Kryvenko, Mark L. Gonzalgo, Bruno Nahar, Chad Ritch, Dipen J. Parekh, Sanoj Punnen, and Sabika Sadiq Tarek AjamiTarek Ajami , Hui YuHui Yu , Yuval AvdaYuval Avda , Nachiketh Soodana-PrakashNachiketh Soodana-Prakash , Sandra GastonSandra Gaston , Alan PollackAlan Pollack , Brandon MahalBrandon Mahal , Radka StoyanovaRadka Stoyanova , Aleksandr KryvenkoAleksandr Kryvenko , Mark L. GonzalgoMark L. Gonzalgo , Bruno NaharBruno Nahar , Chad RitchChad Ritch , Dipen J. ParekhDipen J. Parekh , Sanoj PunnenSanoj Punnen , and Sabika SadiqSabika Sadiq View All Author Informationhttps://doi.org/10.1097/01.JU.0001008896.93851.5b.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer is heterogeneous and multi-focal, and biopsy sampling often under-samples the tumor or samples different tumor foci. Such multiple sampling may cause molecular heterogeneity that leads to an underestimation of risk. Consequently, this impacts treatment decision making and management in localized prostate cancer. Herein, we evaluate the degree of variability in genetic alterations, and genomic risk between different biopsy cores with respect to the sampling method (targeted vs systematic) and MRI phenotype (PIRADS score). METHODS: A total of 348 biopsy samples from 156 patients from the Miami MRI selection for Active Surveillance versus Treatment (MAST) trial (NCT02242773) were used in this study. Across the whole time-course, all biopsy cores with successful gene expression profiling were categorized by mpMRI targeted (110 samples) or template (187 samples) sampling. Cores of higher Gleason score from each group were selected. Variation in expression was analyzed across biopsy samples from same patients. RESULTS: The Decipher genomic score (DGS) was statistically different across template or targeted biopsy in unpaired analysis (p=0.02), but no difference in paired analysis. Of the different molecular pathways, there was no difference regarding gene expression between both groups, except for E2F transcription factor. MRI targeted biopsy Decipher genomic score did not vary according to PIRADS score (p=0.6). Angiogenesis pathway, E2F transcription factor pathway, G2/M checkpoint pathway were highly expressed in PIRADS 5 lesions, whereas estrogen response signaling was lower in PIRADS 5. Among Gleason 6 disease, DGS was comparable across PIRADS lesions (p=0.63). CONCLUSIONS: mpMRI sampling could lead to could result in better genomic assessment for prostate cancer, however, radiologic lesion scoring is not correlated to the genomic risk. No differences in genomic risk were found in GG1 disease across PIRADS scores. In low risk prostate cancer, no correlation exist between genomic risk and MRI phenotype. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e678 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tarek Ajami More articles by this author Hui Yu More articles by this author Yuval Avda More articles by this author Nachiketh Soodana-Prakash More articles by this author Sandra Gaston More articles by this author Alan Pollack More articles by this author Brandon Mahal More articles by this author Radka Stoyanova More articles by this author Aleksandr Kryvenko More articles by this author Mark L. Gonzalgo More articles by this author Bruno Nahar More articles by this author Chad Ritch More articles by this author Dipen J. Parekh More articles by this author Sanoj Punnen More articles by this author Sabika Sadiq More articles by this author Expand All Advertisement PDF downloadLoading ...