MP86-16 A MULTI-CENTER ANALYSIS OF PROSTATE CANCER (PCA) TREATMENT AMONG VETERANS FOLLOWING INTRODUCTION OF THE 17-GENE GENOMIC PROSTATE SCORE (GPS) ASSAY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making V1 Apr 2017MP86-16 A MULTI-CENTER ANALYSIS OF PROSTATE CANCER (PCA) TREATMENT AMONG VETERANS FOLLOWING INTRODUCTION OF THE 17-GENE GENOMIC PROSTATE SCORE (GPS) ASSAY Julie Lynch, Megan Rothney, Raoul Salup, Cesar Ercole, Sharad Mathur, David Duchene, Joseph Basler, Javier Hernandez, Michael Liss, Michael Porter, Jonathan L. Wright, Michael Risk, Mark Garzotto, Olga Efimova, Michael Kemeter, Bela Denes, Phillip Febbo, and Atreya Dash Julie LynchJulie Lynch More articles by this author , Megan RothneyMegan Rothney More articles by this author , Raoul SalupRaoul Salup More articles by this author , Cesar ErcoleCesar Ercole More articles by this author , Sharad MathurSharad Mathur More articles by this author , David DucheneDavid Duchene More articles by this author , Joseph BaslerJoseph Basler More articles by this author , Javier HernandezJavier Hernandez More articles by this author , Michael LissMichael Liss More articles by this author , Michael PorterMichael Porter More articles by this author , Jonathan L. WrightJonathan L. Wright More articles by this author , Michael RiskMichael Risk More articles by this author , Mark GarzottoMark Garzotto More articles by this author , Olga EfimovaOlga Efimova More articles by this author , Michael KemeterMichael Kemeter More articles by this author , Bela DenesBela Denes More articles by this author , Phillip FebboPhillip Febbo More articles by this author , and Atreya DashAtreya Dash More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2699AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active Surveillance (AS), a recommended management approach for low risk PCa, has been widely implemented within VA Medical Centers (VAMCs). However, Veteran characteristics such as age, race, and Agent Orange (AO) exposure may limit use of AS in some patients. The GPS test uses tumor biology to predict likelihood of favorable pathology. GPS may improve risk stratification for patients who are perceived as higher risk. To date, no published studies describe treatment patterns for Veterans following use of genomic tests. This study compares treatment patterns before and after introduction of the GPS assay within 6 VAMCs. METHODS Men with newly diagnosed, NCCN very low, low, or intermediate risk PCa were eligible. We established treatment patterns in an untested patient cohort by reviewing charts from 2013-2014. From 2015-2016, we introduced the GPS assay within these same VAMCs in a prospective study. Six months after biopsy results, we reviewed charts to establish treatments patterns for both untested and tested Veterans. RESULTS There were 200 men in the untested cohort and 190 men in the tested cohort. Patient characteristics were similar across groups. AS increased by 12% overall. The largest increase was among patients under age 60 (33% increase). AS increased in all NCCN risk groups with the largest increases in NCCN low risk (16%) and across racial subgroups (11% Caucasian, 16% Black, 20% Other). Veterans exposed to AO showed a small decrease in AS, while Veterans without exposure showed a 19% increase in AS. Median GPS was similar across racial groups and between Veterans exposed and not exposed to AO. CONCLUSIONS In clinically similar cohorts of untested and tested Veterans, implementation of the GPS assay increased use of AS across all age, risk, and racial groups. The assay showed similar biological risk between Caucasians and Blacks and Veterans exposed and not exposed to AO. GPS may be a useful tool to refine risk assessment of PCa and to increase the already high rates of AS among clinically and biologically low risk patients, regardless of their race and AO exposure. Future studies of Black and AO exposed Veterans, including persistence on AS, are needed confirm these findings. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1162-e1163 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Julie Lynch More articles by this author Megan Rothney More articles by this author Raoul Salup More articles by this author Cesar Ercole More articles by this author Sharad Mathur More articles by this author David Duchene More articles by this author Joseph Basler More articles by this author Javier Hernandez More articles by this author Michael Liss More articles by this author Michael Porter More articles by this author Jonathan L. Wright More articles by this author Michael Risk More articles by this author Mark Garzotto More articles by this author Olga Efimova More articles by this author Michael Kemeter More articles by this author Bela Denes More articles by this author Phillip Febbo More articles by this author Atreya Dash More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...