MP1-10 VALIDATION OF AN ACTIVE SURVEILLANCE THRESHOLD FOR THE CCP SCORE IN CONSERVATIVELY MANAGED MEN WITH LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 2015MP1-10 VALIDATION OF AN ACTIVE SURVEILLANCE THRESHOLD FOR THE CCP SCORE IN CONSERVATIVELY MANAGED MEN WITH LOCALIZED PROSTATE CANCER Jack Cuzick, Steven Stone, Gabrielle Fisher, Zi Hua Yang, Bernard North, Daniel Berney, Luis Beltran, David Greenberg, Henrik Møller, Julia Reid, Alexander Gutin, Jerry Lanchbury, Michael Brawer, and Peter Scardino Jack CuzickJack Cuzick More articles by this author , Steven StoneSteven Stone More articles by this author , Gabrielle FisherGabrielle Fisher More articles by this author , Zi Hua YangZi Hua Yang More articles by this author , Bernard NorthBernard North More articles by this author , Daniel BerneyDaniel Berney More articles by this author , Luis BeltranLuis Beltran More articles by this author , David GreenbergDavid Greenberg More articles by this author , Henrik MøllerHenrik Møller More articles by this author , Julia ReidJulia Reid More articles by this author , Alexander GutinAlexander Gutin More articles by this author , Jerry LanchburyJerry Lanchbury More articles by this author , Michael BrawerMichael Brawer More articles by this author , and Peter ScardinoPeter Scardino More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.173AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) is an increasingly popular treatment modality for men with localized prostate cancer. However, better risk stratification is needed to appropriately select men for AS. The cell cycle progression (CCP) score (based on measuring the expression levels of CCP genes) has proven to be a robust predictor of prostate cancer outcomes in various clinical settings, including in conservatively managed cohorts. Here, we present a validation of an AS threshold for a predefined score that combines CCP with CAPRA (combined clinical CCP risk (CCR) score) for predicting prostate cancer mortality (PCM) in conservatively managed patients. METHODS We determined the CCR score distribution in 505 men who were tested in our clinical laboratory and, based on their clinical characteristics only, might typically be considered for AS. Specifically, the training cohort consisted of men who had Gleason score ≤ 3+4; PSA < 10 ng/ml; < 25% cores positive; and clinical stage ≤ T2a. A threshold CCR score of 0.80 was selected such that 90% of the men in the training cohort had scores below the threshold. The performance characteristics of the threshold were then evaluated in two independent cohorts of conservatively managed men (TAPG1 [N=180] and TAPG2 [N=585]). As reported previously, the CCP score was a strong prognostic indicator in both cohorts. Survival data were censored at 10 years. RESULTS The primary pre-planned analysis called for evaluating the CCR threshold on TAPG2. There were 60 men (of 585) below the threshold in the validation cohort and the threshold validated, dichotomizing the cohort into high and low risk groups (log rank P-value = 0.0008). There were no deaths in patients below the threshold and the Cox proportional hazard estimate of 10-year PCM associated with the CCR threshold was 3.3%. The 10-year risk of PCM associated with the threshold in the combined cohort (TAPG1 and TAPG2) was 3.2%, and as before, there were no observed prostate cancer deaths in patients below the threshold. CONCLUSIONS For patients considering deferred treatment, the CCR score provides significant prognostic information at disease diagnosis. The threshold presented here was derived from the 'typical' risk of PSM for AS patients, and it can be used to guide patient selection for AS based on an integrated view of risk assessment. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e4 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jack Cuzick More articles by this author Steven Stone More articles by this author Gabrielle Fisher More articles by this author Zi Hua Yang More articles by this author Bernard North More articles by this author Daniel Berney More articles by this author Luis Beltran More articles by this author David Greenberg More articles by this author Henrik Møller More articles by this author Julia Reid More articles by this author Alexander Gutin More articles by this author Jerry Lanchbury More articles by this author Michael Brawer More articles by this author Peter Scardino More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...