Zachary Kornberg1, Janet E Cowan1, Antonio C Westphalen2, Matthew R Cooperberg1,3, June M Chan1,3, Shoujun Zhao1, Katsuto Shinohara1, Peter R Carroll1. 1. Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California. 2. Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California. 3. Departments of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California.
Abstract
PURPOSE: The OncotypeDx® GPS (Genomic Prostate Score®) is a 17-gene RNA expression assay intended to help guide treatment decisions in men diagnosed with prostate cancer. The PI-RADS™ (Prostate Imaging Reporting and Data System) version 2 was developed to standardize the risk stratification of lesions identified on multiparametric prostate magnetic resonance imaging. We sought to determine whether these tests are associated with an increased risk of biopsy upgrading in men on active surveillance. MATERIALS AND METHODS: We identified all patients on active surveillance at the University of California-San Francisco who had low/intermediate risk prostate cancer (prostate specific antigen 20 ng/ml or less and clinical stage T1/T2) and Gleason score 6 disease who underwent multiple biopsies and had a GPS available and/or had undergone multiparametric prostate magnetic resonance imaging with an available PI-RADS version 2 score. The primary study outcome was biopsy upgrading, defined as an increase in the Gleason score from 3 + 3 to 3 + 4 or greater, which was analyzed by Cox proportional hazards regression. RESULTS: Of the men 140 had only GPS test findings, 169 had only a PI-RADS version 2 score and 131 had both data. Each 5-unit increase in the GPS was associated with an increased risk of biopsy upgrading (HR 1.28, 95% CI 1.19-1.39, p <0.01). PI-RADS scores of 5 vs 1-2 (HR 4.38, 95% CI 2.36-8.16, p <0.01) and 4 vs 1-2 (HR 2.62, 95% CI 1.45-4.76, p <0.01) were also associated with an increased risk of a biopsy upgrade. On subanalysis of patients with GPS and PI-RADS version 2 scores the GPS was associated with biopsy upgrading, adding value to the clinical covariates (partial likelihood ratio p = 0.01). CONCLUSIONS: A higher GPS or a PI-RADS version 2 score of 4 or 5 was associated with an increased risk of biopsy upgrading.
PURPOSE: The OncotypeDx® GPS (Genomic Prostate Score®) is a 17-gene RNA expression assay intended to help guide treatment decisions in men diagnosed with prostate cancer. The PI-RADS™ (Prostate Imaging Reporting and Data System) version 2 was developed to standardize the risk stratification of lesions identified on multiparametric prostate magnetic resonance imaging. We sought to determine whether these tests are associated with an increased risk of biopsy upgrading in men on active surveillance. MATERIALS AND METHODS: We identified all patients on active surveillance at the University of California-San Francisco who had low/intermediate risk prostate cancer (prostate specific antigen 20 ng/ml or less and clinical stage T1/T2) and Gleason score 6 disease who underwent multiple biopsies and had a GPS available and/or had undergone multiparametric prostate magnetic resonance imaging with an available PI-RADS version 2 score. The primary study outcome was biopsy upgrading, defined as an increase in the Gleason score from 3 + 3 to 3 + 4 or greater, which was analyzed by Cox proportional hazards regression. RESULTS: Of the men 140 had only GPS test findings, 169 had only a PI-RADS version 2 score and 131 had both data. Each 5-unit increase in the GPS was associated with an increased risk of biopsy upgrading (HR 1.28, 95% CI 1.19-1.39, p <0.01). PI-RADS scores of 5 vs 1-2 (HR 4.38, 95% CI 2.36-8.16, p <0.01) and 4 vs 1-2 (HR 2.62, 95% CI 1.45-4.76, p <0.01) were also associated with an increased risk of a biopsy upgrade. On subanalysis of patients with GPS and PI-RADS version 2 scores the GPS was associated with biopsy upgrading, adding value to the clinical covariates (partial likelihood ratio p = 0.01). CONCLUSIONS: A higher GPS or a PI-RADS version 2 score of 4 or 5 was associated with an increased risk of biopsy upgrading.
Authors: Justin R Gregg; John W Davis; Chad Reichard; Xuemei Wang; Mary Achim; Brian F Chapin; Louis Pisters; Curtis Pettaway; John F Ward; Seungtaek Choi; Quynh-Nhu Nguyen; Deborah Kuban; Richard Babaian; Patricia Troncoso; Lydia T Madsen; Christopher Logothetis; Jeri Kim Journal: Urology Date: 2019-12-30 Impact factor: 2.649
Authors: Daniel W Lin; Yingye Zheng; Jesse K McKenney; Marshall D Brown; Ruixiao Lu; Michael Crager; Hilary Boyer; Maria Tretiakova; James D Brooks; Atreya Dash; Michael D Fabrizio; Martin E Gleave; Suzanne Kolb; Michael Liss; Todd M Morgan; Ian M Thompson; Andrew A Wagner; Athanasios Tsiatis; Andrea Pingitore; Peter S Nelson; Lisa F Newcomb Journal: J Clin Oncol Date: 2020-03-04 Impact factor: 44.544
Authors: Joseph M Norris; Benjamin S Simpson; Marina A Parry; Clare Allen; Rhys Ball; Alex Freeman; Daniel Kelly; Hyung L Kim; Alex Kirkham; Sungyong You; Veeru Kasivisvanathan; Hayley C Whitaker; Mark Emberton Journal: Eur Urol Open Sci Date: 2020-07