Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer

Abstract Objective To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate‐risk (FIR) prostate cancer (PCa) patients who received the 17‐gene Genomic Prostate Score (GPS) assay. Material and Methods Contemporary data were collected from academic and...

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Main Authors: Eric Margolis, Benjamin H. Lowentritt, Christopher M. Pieczonka, John P. Bennett, Marina Pavlova, Joao Paulo Zambon, Jack Groskopf, Edward Uchio
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:BJUI Compass
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Online Access:https://doi.org/10.1002/bco2.494
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author Eric Margolis
Benjamin H. Lowentritt
Christopher M. Pieczonka
John P. Bennett
Marina Pavlova
Joao Paulo Zambon
Jack Groskopf
Edward Uchio
author_facet Eric Margolis
Benjamin H. Lowentritt
Christopher M. Pieczonka
John P. Bennett
Marina Pavlova
Joao Paulo Zambon
Jack Groskopf
Edward Uchio
author_sort Eric Margolis
collection DOAJ
description Abstract Objective To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate‐risk (FIR) prostate cancer (PCa) patients who received the 17‐gene Genomic Prostate Score (GPS) assay. Material and Methods Contemporary data were collected from academic and large community group practices across the United States. Eligible patients had localized PCa classified as FIR per NCCN guidelines and received a GPS report between May 2017 and April 2019. Higher GPS results (scale: 0–100) were associated with a higher risk of adverse outcomes. The proportion of patients selecting AS was calculated with 95% confidence intervals. Uni‐and multivariable logistic regression analyses were performed to determine the association between AS selection and relevant covariates. Results There were 324 eligible patients (Gleason Score 3 + 4, 79%; PSA 10–20 ng/ml, 19%; clinical stage T2b‐T2c, 2%; median percent positive cores, 16.7%; median GPS result, 26). The distribution of GPS results was 0–19 (23%), 20–40 (60%), and 41–100 (16%). Overall, 31% (95% CI 26%, 36%) selected AS: 58% (46%, 69%) with GPS 0–19, 27% (21%, 33%) with GPS 20–40, and 6% (1%, 16%) with GPS 41–100. In univariable models, the Gleason score, percent positive cores, PSA, and GPS results were significantly associated with AS selection. In a multivariable model, the percent positive cores and the GPS result remained significantly associated with AS selection. AS persistence was 91% (82%, 95%) at 12 months. Conclusions The GPS result and percent positive cores appear associated with AS use after controlling for relevant clinical variables in NCCN FIR prostate cancer patients.
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spelling doaj-art-7f683a2f4dfd46fc90d2ffe11d1f3ce62025-08-20T01:49:58ZengWileyBJUI Compass2688-45262025-03-0163n/an/a10.1002/bco2.494Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancerEric Margolis0Benjamin H. Lowentritt1Christopher M. Pieczonka2John P. Bennett3Marina Pavlova4Joao Paulo Zambon5Jack Groskopf6Edward Uchio7Hackensack Meridian School of Medicine Nutley NJ USAChesapeake Urology Towson MD USAAssociated Medical Professionals of NY Syracuse NY USAExact Sciences Corporation Redwood City CA USAExact Sciences Corporation Redwood City CA USAMDx Health Corporation Irvine CA USAMDx Health Corporation Irvine CA USAUniversity of California Orange CA USAAbstract Objective To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate‐risk (FIR) prostate cancer (PCa) patients who received the 17‐gene Genomic Prostate Score (GPS) assay. Material and Methods Contemporary data were collected from academic and large community group practices across the United States. Eligible patients had localized PCa classified as FIR per NCCN guidelines and received a GPS report between May 2017 and April 2019. Higher GPS results (scale: 0–100) were associated with a higher risk of adverse outcomes. The proportion of patients selecting AS was calculated with 95% confidence intervals. Uni‐and multivariable logistic regression analyses were performed to determine the association between AS selection and relevant covariates. Results There were 324 eligible patients (Gleason Score 3 + 4, 79%; PSA 10–20 ng/ml, 19%; clinical stage T2b‐T2c, 2%; median percent positive cores, 16.7%; median GPS result, 26). The distribution of GPS results was 0–19 (23%), 20–40 (60%), and 41–100 (16%). Overall, 31% (95% CI 26%, 36%) selected AS: 58% (46%, 69%) with GPS 0–19, 27% (21%, 33%) with GPS 20–40, and 6% (1%, 16%) with GPS 41–100. In univariable models, the Gleason score, percent positive cores, PSA, and GPS results were significantly associated with AS selection. In a multivariable model, the percent positive cores and the GPS result remained significantly associated with AS selection. AS persistence was 91% (82%, 95%) at 12 months. Conclusions The GPS result and percent positive cores appear associated with AS use after controlling for relevant clinical variables in NCCN FIR prostate cancer patients.https://doi.org/10.1002/bco2.494active surveillancebiomarkersFavourable intermediate‐riskgenomic testingprostate cancer
spellingShingle Eric Margolis
Benjamin H. Lowentritt
Christopher M. Pieczonka
John P. Bennett
Marina Pavlova
Joao Paulo Zambon
Jack Groskopf
Edward Uchio
Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
BJUI Compass
active surveillance
biomarkers
Favourable intermediate‐risk
genomic testing
prostate cancer
title Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
title_full Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
title_fullStr Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
title_full_unstemmed Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
title_short Genomic prostate score and treatment selection in favourable intermediate‐risk prostate cancer
title_sort genomic prostate score and treatment selection in favourable intermediate risk prostate cancer
topic active surveillance
biomarkers
Favourable intermediate‐risk
genomic testing
prostate cancer
url https://doi.org/10.1002/bco2.494
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