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A prognostic risk estimator that incorporates genomic data and clinical factors could allow for the elimination of androgen deprivation therapy (ADT) in some men with intermediate- or high-risk prostate cancer following radiation therapy (RT), a researcher reported.
In a retrospective validation study involving nearly 750 men who received dose-escalated RT, those with a combined clinical cell-cycle risk (CCR) score below a cutoff of 2.112 had a 10-year risk of distant metastasis of just 4.1%, regardless of National Comprehensive Cancer Network (NCCN) risk group, while those above the threshold had a 10-year risk of 25.3%, reported Jonathan Tward, MD, PhD, of the University of Utah in Salt Lake City.
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Scores with the 22-gene Decipher genomic classifier (GC) were independently associated with risk for metastasis, prostate cancer-specific mortality, and overall survival among men with recurrent prostate cancer treated with salvage radiotherapy with or without bicalutamide.
These results suggest that not all men with biochemically recurrent disease after surgery will benefit from hormone therapy, reported Felix Y. Feng, MD, of the University of California San Francisco, and colleagues in
Using specimens from the phase III NRG/RTOG9601 clinical trial, Feng and colleagues generated GC scores from 352 patients with median follow-up of 13 years. Patient GC scores were calculated on a continuous scale from 0 (lowest) to 1 (highest). Scores were then classified as low (42%), intermediate (38%), or high (20%) using previously established 0.45 and 0.60 as cutoffs.