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| Status |
Public on Jul 12, 2018 |
| Title |
Using biopsies to improve risk stratification in patients with prostate cancer treated with radical radiation therapy |
| Organism |
Homo sapiens |
| Experiment type |
Expression profiling by array
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| Summary |
Background: Radiotherapy is an effective treatment of intermediate/high-risk locally advanced prostate cancer, however,>30% of patients relapse within 5 years. Clinicopathological parameters currently fail to identify patients prone to systemic relapse and those whom treatment intensification may be beneficial. The purpose of this study was to independently validate prognostics assays in a cohort of diagnostic biopsies from patients treated with radical radiotherapy and androgen deprivation therapy.
Patients and methods: Independent clinical validation in a cohort of diagnostic biopsies from patients treated with radical radiotherapy and androgen deprivation therapy. Multivariable Cox proportional hazard regression analysis was used to assess assay performance in predicting biochemical failure-free survival (BFFS) and metastasis free survival (MFS).
Results: Gene expression analysis was carried out in 248 patients from the independent validation cohort and the Metastatic Assay applied. Ten-year MFS was 72% for Metastatic Assay positive patients and 94% for Metastatic Assay negative patients [HR 3.21 (1.35–7.67); P=0.003]. On multivariable analysis the Metastatic Assay remained predictive for development of distant metastases [HR 2.71 (1.11–6.63); P=0.030]. The assay retained independent prognostic performance for MFS when assessed with the Cancer of the Prostate Assessment Score (CAPRA) [HR 3.23 (1.22–8.59); P=0.019] whilst CAPRA itself was not significant [HR 1.88, (0.52–6.77); P=0.332].
Conclusions: The Metastatic Assay demonstrated significant prognostic performance in patients treated with radical radiotherapy both alone and independent of standard clinical and pathological variables. The Metastatic Assay could have clinical utility when deciding upon treatment intensification in high-risk patients.
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| Overall design |
For this validation cohort, 248 localized/locally advanced prostate cancer patients commencing radical radiotherapy (with ADT) were included. Patients were treated with 70–74 Gy external beam radiation therapy (EBRT) in 2 Gy fractions with 3D conformal or intensity modulated techniques over 7–7.5 weeks. Node negative patients received elective pelvic nodal irradiation at the physician’s discretion; node-positive patients had radiotherapy to pelvic nodal regions. Short (6months) or long (>6–36months) course ADT commenced at least 3 months before radiation with LHRH agonists or antiandrogens.
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| Contributor(s) |
Jain S, Lyons CA, Walker SM, McQuaid S, Hynes SO, Mitchell DM, Pang B, Logan GE, McCavigan AM, O'Rourke D, McArt DG, McDade SS, Mills IG, Prise KM, Knight LA, Steele CJ, Medlow PW, Berge V, Katz B, Lobaw DA, Harkin DP, James JA, O'Sullivan JM, Kennedy RD, Waugh DJ |
| Citation(s) |
29045551 |
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| Submission date |
Jul 11, 2018 |
| Last update date |
Oct 23, 2018 |
| Contact name |
Suneil Jain |
| Organization name |
Queen's University Belfast
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| Street address |
97 Lisburn Road
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| City |
Belfast |
| ZIP/Postal code |
BT9 7BL |
| Country |
United Kingdom |
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| Platforms (1) |
| GPL25318 |
[ADXPCv1a520642] Almac Diagnostics Prostate Disease Specific Array (DSA) |
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| Samples (248)
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| Relations |
| BioProject |
PRJNA480607 |
| Supplementary file |
Size |
Download |
File type/resource |
| GSE116918_RAW.tar |
1.1 Gb |
(http)(custom) |
TAR (of CEL) |
| Processed data included within Sample table |
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