Genomic Classifier for Guiding Treatment of Intermediate-Risk Prostate Cancers to Dose-Escalated Image Guided Radiation Therapy Without Hormone Therapy

International Journal of Radiation Oncology, Biology, Physics
Alejandro BerlinMelvin L K Chua

Abstract

The National Comprehensive Cancer Network (NCCN) has recently endorsed the stratification of intermediate-risk prostate cancer (IR-PCa) into favorable and unfavorable subgroups and recommend the addition of androgen deprivation therapy (ADT) to radiation therapy (RT) for unfavorable IR-PCa. Recently, more accurate prognostication was demonstrated by integrating a 22-feature genomic classifier (GC) to the NCCN stratification system. Here, we test the utility of the GC to better identify patients with IR-PCa who are sufficiently treated by RT alone. We identified a novel cohort comprising 121 patients with IR-PCa treated with dose-escalated image guided RT (78 Gy in 39 fractions) without ADT. GC scores were derived from tumors sampled in diagnostic biopsies. Multivariable analyses, including both NCCN subclassification and GC scores, were performed for biochemical failure (prostate-specific antigen nadir + 2 ng/mL) and metastasis occurrence. By NCCN subclassification, 33 (27.3%) and 87 (71.9%) of men were classified as having favorable and unfavorable IR-PCa, respectively (1 case unclassifiable). GC scores were high in 3 favorable IR-PCa and low in 60 unfavorable IR-PCa. Higher GC scores, but not NCCN risk subgroups, were associa...Continue Reading

Citations

May 6, 2019·BJU International·Noam David FineHasan Dani
Jan 25, 2020·The Cancer Journal·Rachel M Glicksman, Alejandro Berlin
Dec 13, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Scott E EggenerHimisha Beltran
Jun 18, 2020·Cancers·Felipe CouñagoElia Del Cerro
Sep 5, 2020·Expert Review of Molecular Diagnostics·Fernando López-CamposFelipe Couñago
Oct 5, 2019·Current Opinion in Urology·Randy A VinceTodd M Morgan
May 3, 2020·Nature Reviews. Urology·Yiannis PhilippouRichard J Bryant
Dec 17, 2019·Clinical Oncology : a Journal of the Royal College of Radiologists·R T Dess, D E Spratt
Dec 10, 2020·European Urology·Neil K JairathDaniel E Spratt
Apr 27, 2021·International Journal of Radiation Oncology, Biology, Physics·Abdenour NabidLuis Souhami
May 25, 2021·Frontiers in Oncology·Sophia C Kamran, Jason A Efstathiou
Dec 7, 2020·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Abdenour NabidLuis Souhami

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