Genomic Risk Scores Testing for Patients With Prostate Cancer

A study presented by Dr. Jenna Winebaum at the Society of Urologic Oncology Annual Meeting sought to determine if genomic risk scores (GRS) testing could assist researchers in selecting for focal disease in patients with prostate cancer.

While focal therapy is recognized as a valid treatment strategy, Dr. Winebaum and colleagues noted the need for additional research into selection strategies that could minimize recurrence. Prior research has demonstrated that GRS testing can predict adverse pathology at radical prostatectomy (RP), risk of metastasis, and prostate cancer-specific mortality.

The study focused on the efficacy of GRS on biopsy results consistent with focal disease to predict the amount of disease apparent on whole-gland findings.

The trial’s primary outcome was the potential for focal or hemi-gland ablation following analysis of the final pathologic specimen. Researchers defined this outcome using Gleason grade group (GG) 2-3 disease presenting with good focality on RP. The secondary outcome was good focality on RP separate from GG.

Of the 3023 participating patients who had biopsy-mapped disease and received RP, physicians performed GRS testing on 507 whose data were included. Researchers reported that 149 (30%) patients met the requirements for ablation based on the initial biopsy, while 377 (74%) presented with low-risk GRS and 130 (26%) had high-risk GRS.

Researchers found that major adverse pathology was not connected to focality (chi-square, P=.41) at RP. They concluded that a patient’s GRS score was not correlated with good focality at RP. There was also no relationship between magnetic resonance imaging and focality at RP.

The study’s limitations included surgery selection criteria and the inclusion of different treatment therapies.

Dr. Winebaum and colleagues concluded that GRS testing did not benefit selection for focal disease. “This emphasizes the importance of continuing to work to improve patient selection parameters for focal therapy,” they wrote.