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Prostate Cancer: Markers (MP60): Moderated Poster 60: Monday, September 13, 2021

MP60-16 CELL CYCLE PROGRESSION SCORE AND PTEN AS PROGNOSTIC FACTORS FOR METASTASIS IN INTERMEDIATE AND HIGH RISK PROSTATE CANCER OVERALL, AND IN THOSE WHO RECEIVED SALVAGE RADIOTHERAPY

Trock, Bruce; Mabey, Brent; Vidal, Igor; Glavaris, Stephanie; Jones, Tracy; Han, Misop; Partin, Alan; Cohen, Todd; Stone, Steven; De Marzo, Angelo

doi: 10.1097/JU.0000000000002095.16
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INTRODUCTION AND OBJECTIVE:

The cell cycle progression (CCP) score and PTEN have never been evaluated together for metastasis-free survival (MFS) in a prostatectomy (RP) cohort of men with intermediate and high risk (IHR) prostate cancer (PCa), nor in IHR patients who also received salvage radiation (SRT) alone or with androgen deprivation (SRT+ADT). We evaluated CCP score and PTEN in both settings.

METHODS:

Men received RP at Johns Hopkins from 2007-2015. Paraffin-embedded RP tissue was analyzed blind to outcome at Myriad Genetics for CCP score with qRT-PCR, and PTEN by immunohistochemistry. For overall evaluation of CCP and PTEN a case-cohort sample of IHR men was selected. Separately, a cohort of IHR men with biochemical recurrence who received SRT or SRT+ADT were also sampled to evaluate men at particularly high risk. MFS was analyzed with the proportional hazards model (weighted for case-cohort design for overall analysis), and adjusted for Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S). The cell-cycle risk (CCR) score, a fixed algorithm combining CCP and CAPRA-S was also analyzed in both contexts. Data were analyzed independently by Johns Hopkins and Myriad Genetics.

RESULTS:

The case-cohort included 209 men: 47% with Gleason score >4+3, 48% extra-prostatic extension, and 18% with seminal vesicle or lymph node involvement; 42 (20%) developed metastasis. In multivariable analysis, CCP and CAPRA-S were statistically significant, but not PTEN (Table section A). CCR was also strongly prognostic: HR=7.9 (95% CI 4.4, 14.5) per unit, p<0.00001. SRT (56%) or SRT+ADT (44%) were received by 172 IHR men, of whom 78% had Gleason >4+3, 48% extra-prostatic extension, and 34% seminal vesicle or lymph node involvement; 19 (11%) developed metastases. Again, CCP and CAPRA-S, but not PTEN, were statistically significant for MFS (Table section B). CCR was also statistically significant: HR=1.7 (95% CI 1.2, 2.4), p=0.002.

CONCLUSIONS:

This is the first comparison, in a recent cohort of IHR men, of CCP and PTEN as risk factors for metastasis, and first evaluation in IHR men receiving SRT. In both settings, CCP, but not PTEN, was significantly associated with MFS, adjusted for CAPRA-S. CCR, a fixed algorithm combining CCP and CAPRA-S was also significant in both settings.

Source of Funding:

Myriad Genetics, Inc., and NIH 5P50CA058236-17 Johns Hopkins Specialized Program of Research Excellence (SPORE) in Prostate Cancer

© 2021 by American Urological Association Education and Research, Inc.