Genomic Prostate Score: A New Tool to Assess Prognosis and Optimize Radiation Therapy Volumes and ADT in Intermediate-Risk Prostate Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients and Study Design
2.2. Biopsy and Tumor Selection Process
2.3. GPS Assay Description
2.4. Endpoints
3. Results
3.1. Patients’ Selection Process
3.2. Patients Characteristics
3.3. Risk Stratification
3.4. Correlation between GPS and Histological Features
3.5. GPS IMPACT on Therapeutic Decision Making and RT Volumes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | N = 30 | % |
---|---|---|
Age (years) | ||
Median (range) | 70 (45–79) | - |
PSA (ng/mL) | ||
Median (range) | 7 (0.9–16) | - |
Clinical T Stage | ||
T1 | 23 | 77 |
T2 | 7 | 23 |
Prostate Volume (mL) | ||
Median (range) | 40 (15–75) | - |
Number of Positive Cores | ||
Median (range) | 7.5 (1–17) | - |
Number of Cores Sampled | ||
Median (range) | 18 (18–22) | - |
Positive Cores/Cores Sampled Ratio | ||
<50% | 18 | 60 |
≥50% | 12 | 40 |
NCCN Risk Group | ||
Intermediate favorable | 18 | 60 |
Intermediate unfavorable | 12 | 40 |
Upfront Treatment | ||
Surgery | 23 | 77 |
Radiation therapy | 7 | 23 |
Patient Number | NCCN Clinical Risk Group | Decision Radiation + Hormonal Therapy (Based on Clinical Factors) | GPS | NCCN + GPS Risk Group | Estimated Metastatic Risk at 10 Years (%) Based on GPS Validation Studies | Estimated Prostate Cancer Death at 10 Years (%) Based on GPS Validation Studies | Decision Radiation Based on NCCN + GPS | Impact of GPS |
---|---|---|---|---|---|---|---|---|
1 | Unfavorable intermediate | RT prostate alone with ADT (short term) | 17 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | De-escalation |
2 | Favorable intermediate | RT prostate alone with ADT (short term) | 53 | High | 17 | 3 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
3 | Favorable intermediate | RT prostate alone without ADT | 33 | Unfavorable intermediate | 7 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
4 | Unfavorable intermediate | RT prostate alone without ADT | 37 | Unfavorable intermediate | 9 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
5 | Unfavorable intermediate | RT prostate alone without ADT | 19 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | No change |
6 | Favorable intermediate | RT prostate alone with ADT (short term) | 39 | Unfavorable intermediate | 10 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
7 | Favorable intermediate | RT prostate alone without ADT | 40 | Unfavorable intermediate | 10 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
8 | Favorable intermediate | RT prostate alone without ADT | 30 | Unfavorable intermediate | 7 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
9 | Favorable intermediate | RT prostate alone without ADT | 46 | High | 13 | 2 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
10 | Favorable intermediate | RT prostate alone without ADT | 70 | High | 23 | 4 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
11 | Unfavorable intermediate | RT prostate alone without ADT | 25 | Unfavorable intermediate | 5 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
12 | Favorable intermediate | RT prostate alone without ADT | 47 | High | 13 | 2 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
13 | Favorable intermediate | RT prostate alone without ADT | 36 | Unfavorable intermediate | 8 | 1 | RT prostate alone without ADT | Intensification |
14 | Unfavorable intermediate | RT prostate alone with ADT (short term) | 39 | Unfavorable intermediate | 10 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
15 | Unfavorable intermediate | RT prostate alone without ADT | 42 | High | 11 | 1 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
16 | Favorable intermediate | RT prostate alone without ADT | 19 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | No change |
17 | Favorable intermediate | RT prostate alone without ADT | 18 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | No change |
18 | Favorable intermediate | RT prostate alone without ADT | 18 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | No change |
19 | Unfavorable intermediate | RT prostate alone without ADT | 40 | Unfavorable intermediate | 10 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
20 | Favorable intermediate | RT prostate alone without ADT | 56 | High | 19 | 3 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
21 | Favorable intermediate | RT prostate alone without ADT | 26 | Unfavorable intermediate | 6 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
22 | Unfavorable intermediate | RT prostate alone without ADT | 20 | Unfavorable intermediate | 4 | 1 | RT prostate alone with ADT (short term) | Intensification |
23 | Favorable intermediate | RT prostate alone without ADT | 18 | Favorable intermediate | 4 | 1 | RT prostate alone without ADT | no change |
24 | Favorable intermediate | RT prostate alone without ADT | 34 | Unfavorable intermediate | 8 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | Intensification |
25 | Unfavorable intermediate | RT prostate alone with ADT (short term) | 43 | High | 11 | 1 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
26 | Unfavorable intermediate | RT prostate alone without ADT | 58 | High | 20 | 3 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
27 | Favorable intermediate | RT prostate alone without ADT | 47 | High | 12 | 2 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
28 | Unfavorable intermediate | RT prostate alone with ADT (short term) | 55 | High | 18 | 3 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
29 | Favorable intermediate | RT prostate alone without ADT | 53 | High | 17 | 3 | RT of the pelvic nodes and the prostate with ADT (long term) | Intensification |
30 | Unfavorable intermediate | RT of the pelvic nodes and the prostate with ADT (short term) | 39 | Unfavorable intermediate | 10 | 1 | RT of the pelvic nodes and the prostate with ADT (short term) | No change |
Trial Name | Full Name of Trial | Common Name | Phase | Participants (Number) | Status (July 2022) |
---|---|---|---|---|---|
NRG GU009 NCT04513717 | Two studies for patients with high-risk prostate cancer testing less intense treatment for patients with a low gene risk score and testing a more intense treatment with a high gene risk score. | PREDICT-RT | III | 2478 | Recruiting |
NRG GU010 NCT05050084 | Two studies for patients with unfavorable intermediate-risk prostate cancer testing less intense treatment for patients with a low gene risk score and testing a more intense treatment with a high gene risk score. | GUIDANCE | III | 2050 | Recruiting |
NCT04396808 | Genomics in Michigan to adjust outcomes in prostate cancer for men with newly diagnosed favorable-risk prostate cancer. | G-MAJOR | III | 350 | Recruiting |
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Belkacemi, Y.; Debbi, K.; Coraggio, G.; Bendavid, J.; Nourieh, M.; To, N.H.; Cherif, M.A.; Saldana, C.; Ingels, A.; De La Taille, A.; et al. Genomic Prostate Score: A New Tool to Assess Prognosis and Optimize Radiation Therapy Volumes and ADT in Intermediate-Risk Prostate Cancer. Cancers 2023, 15, 945. https://doi.org/10.3390/cancers15030945
Belkacemi Y, Debbi K, Coraggio G, Bendavid J, Nourieh M, To NH, Cherif MA, Saldana C, Ingels A, De La Taille A, et al. Genomic Prostate Score: A New Tool to Assess Prognosis and Optimize Radiation Therapy Volumes and ADT in Intermediate-Risk Prostate Cancer. Cancers. 2023; 15(3):945. https://doi.org/10.3390/cancers15030945
Chicago/Turabian StyleBelkacemi, Yazid, Kamel Debbi, Gabriele Coraggio, Jérome Bendavid, Maya Nourieh, Nhu Hanh To, Mohamed Aziz Cherif, Carolina Saldana, Alexandre Ingels, Alexandre De La Taille, and et al. 2023. "Genomic Prostate Score: A New Tool to Assess Prognosis and Optimize Radiation Therapy Volumes and ADT in Intermediate-Risk Prostate Cancer" Cancers 15, no. 3: 945. https://doi.org/10.3390/cancers15030945