MP38-06 IMPACT OF THREE MEASURES OF INHERITED PROSTATE CANCER RISK ON UPGRADING DURING ACTIVE SURVEILLANCE FOR GRADE GROUP 1 PROSTATE CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP38-06 IMPACT OF THREE MEASURES OF INHERITED PROSTATE CANCER RISK ON UPGRADING DURING ACTIVE SURVEILLANCE FOR GRADE GROUP 1 PROSTATE CANCER Claire De La Calle, Julia Fountain, Sean Fletcher, Yuezhou Jing, Patricia Landis, Jun Wei, Zhuqing Shi, S. Lilly Zheng, Jianfeng Xu, William Isaacs, and Christian Pavlovich Claire De La CalleClaire De La Calle More articles by this author , Julia FountainJulia Fountain More articles by this author , Sean FletcherSean Fletcher More articles by this author , Yuezhou JingYuezhou Jing More articles by this author , Patricia LandisPatricia Landis More articles by this author , Jun WeiJun Wei More articles by this author , Zhuqing ShiZhuqing Shi More articles by this author , S. Lilly ZhengS. Lilly Zheng More articles by this author , Jianfeng XuJianfeng Xu More articles by this author , William IsaacsWilliam Isaacs More articles by this author , and Christian PavlovichChristian Pavlovich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In this study, we sought to evaluate the impact of three measures of inherited risk (rare pathogenic mutation (RPM) carrier status, single nucleotide polymorphism (SNP) -based genetic risk score (GRS) and various definitions of family history (FH)) on upgrading during active surveillance (AS). METHODS: We identified 700 men enrolled in the Johns Hopkins AS registry from 1995 to 2018 with available sequencing data. All men had GG1 disease at diagnosis. A multivariable proportional hazards model was used to assess the association between RPM carrier status, GRS and FH and upgrading defined as the detection of Grade group (GG) ≥2 PCa on a surveillance biopsy, adjusting for age, PSA density, cancer volume metrics, and Eigen values (genetic background). RPM carrier status was defined as being a carrier of any one of the following gene mutations: BRCA1, BRCA2, ATM, PALB2, CHEK2, MLH1, MSH2, MSH6, PMS2, or HOXB13. GRS was defined as: low (<0.5), average (0.5 – 1.5), moderately high (1.5 – 3), and high (≥3). Various definitions of FH were used: any FH of PCa (FHP), any FH of cancer (FHC), high-risk FH of PCa (HR-FHP) and high-risk FH for any cancer (HR-FHC) based on National Comprehensive Cancer Network guidelines, and history of lethal PCa (L-FHP). RESULTS: Among the 700 AS patients, 34 were RPM carriers (4.9%), 31 had a high GRS (4.4%), 174 (24.9%) had a FHP, 36 (5.1%) had a HR-FHP, 517 (73.9%) had a FHC, 153 (21.9%) had a HR-FHC, and 35 (5.0%) had a L-FHP. Overall, 196 (28.0%) patients upgraded on surveillance. There was no significant difference in RPM status, GRS, or FH (using any of the FH definitions) between men who upgraded and men who did not (Table). In addition, men with high GRS and positive FH, and RPM carriers with a positive FH, did not experience more upgrading, regardless of the definition used for FH (Table). On multivariable analysis neither RPM carrier status, GRS or FH (using any of the FH definitions) nor any of the three measures of inherited risk combined were predictors of upgrading (p>0.05). CONCLUSIONS: In a large cohort of AS men with GG1 PCa, neither RPM carrier status, high GRS, positive FH nor combinations of the three predicted upgrading on AS, suggesting that such men can be safely monitored on AS. This study is limited by low number of RPM carriers and low number of men with high GRS. Source of Funding: Ralph T. and Esther L. Warburton Foundation and Dr. Hugh Judge Jewett Fellowship in Urologic Oncology. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e525 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claire De La Calle More articles by this author Julia Fountain More articles by this author Sean Fletcher More articles by this author Yuezhou Jing More articles by this author Patricia Landis More articles by this author Jun Wei More articles by this author Zhuqing Shi More articles by this author S. Lilly Zheng More articles by this author Jianfeng Xu More articles by this author William Isaacs More articles by this author Christian Pavlovich More articles by this author Expand All Advertisement PDF downloadLoading ...