MP1-04 EVALUATION OF GENOMIC SIGNATURES IN INTERMEDIATE TO HIGH RISK MEN TREATED WITH RADICAL PROSTATECTOMY BUT WITHOUT ADDITIONAL THERAPY UPON PSA RISE

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 2015MP1-04 EVALUATION OF GENOMIC SIGNATURES IN INTERMEDIATE TO HIGH RISK MEN TREATED WITH RADICAL PROSTATECTOMY BUT WITHOUT ADDITIONAL THERAPY UPON PSA RISE Michael Johnson, Kasra Yousefi, Nicholas Erho, Voleak Choeurng, Lucia Lam, Helen L. Fedor, Elai Davicioni, Edward Schaeffer, and Ashley Ross Michael JohnsonMichael Johnson More articles by this author , Kasra YousefiKasra Yousefi More articles by this author , Nicholas ErhoNicholas Erho More articles by this author , Voleak ChoeurngVoleak Choeurng More articles by this author , Lucia LamLucia Lam More articles by this author , Helen L. FedorHelen L. Fedor More articles by this author , Elai DavicioniElai Davicioni More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.167AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy (RP) is a primary treatment option for men with intermediate and high risk prostate cancer. Though many will be effectively cured with local therapy alone, these men are by definition at higher risk of adverse pathologic findings and clinical disease recurrence. Several genomic tests are currently on the market for use as risk stratification and prognostic aids. Here we evaluate four previously validated genomic signatures in a natural history cohort of at risk men who received no additional treatment until the time of metastatic progression. METHODS Men with NCCN intermediate or high risk localized prostate cancer treated with RP at the Johns Hopkins Medical Institute (1992–2010) with at least 5 years of post-operative follow up were identified. Only men with initial undetectable PSA after surgery and who received no therapy prior to metastasis detection were included using a case-cohort design (n=337). Random forest modeling in an independent training dataset (n=359) was used to derive risk scores for Decipher, CCP, GPS and Penney genomic signatures as previously described by Erho et al., 2013 and compared to the CAPRA-S risk scores for predicting metastasis 10 years post-RP. RESULTS Risk scores were computed for 260 patients with complete follow up data. Overall, the four signatures had moderate correlations except for the Decipher and Penney signature that had a strong correlation of 0.66. ROC analysis for the survival data for metastasis 10 years post-RP was 0.76, 0.74, 0.62 and 0.62 for Decipher, Penney, CCP and GPS, respectively. In univariable analysis, all four gene signatures were significant predictors of metastatic progression, but in multivariable analysis adjusting for CAPRA-S score, only Decipher (p<0.0001), Penney (p<0.0001) and CCP (p=0.001) retained significance. CONCLUSIONS We evaluated four previously validated prognostic signatures in a natural history after RP cohort of intermediate to high-risk men. Decipher and Penney signatures were the best predictors of metastasis, although all signatures demonstrated some measure of prognostic significance. Future studies aimed at comparing the risk models and their comparative-effectiveness for postoperative decision-making are warranted. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e2 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Johnson More articles by this author Kasra Yousefi More articles by this author Nicholas Erho More articles by this author Voleak Choeurng More articles by this author Lucia Lam More articles by this author Helen L. Fedor More articles by this author Elai Davicioni More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...