New test can predict prostate cancer recurrence in patients after radical prostatectomy

The authors aimed to determine whether the biopsy-based Genomic Prostate Score test could predict cancer recurrence in a racially diverse group after radical prostatectomy.

Active surveillance is an option taken in patients with low-risk prostate cancer (confined to the prostate) which involves no physical treatment, only close monitoring of the cancer to detect any cancer progression. However the ability to truly predict the aggressiveness of tumors has been questioned.

Radical prostatectomy is an active treatment option in prostate cancer that involves surgery to remove the prostate. Biomarkers (indicators of a disease state, often proteins or genes) can be used to predict the return of prostate cancer. They can be used in specific tests to determine the recurrence of prostate cancer, such as the Genomic Prostate Score (GPS) which is based on a particular set of genes. 

This study aimed to determine whether the ‘Genomic Prostate Score (GPS)’ test could detect cancer progression in a racially diverse patient group after radical prostatectomy.

431 patients were used in this study. They had an average age of 62 years and follow-up time of 5.2 years. GPS calculated risk of cancer recurring based on a scale of 0-100.

Using advanced analysis, GPS was the only significant predictive factor in determining time from biopsy (tissue sample removal and analysis) until biochemical recurrence (rising levels of prostate specific antigen – protein elevated in the blood when cancer is present). Every 20-unit GPS increase was associated with an increased risk of cancer recurrence by 2.7 times. Average 5-year risk of biochemical recurrence was 7.5% in those with a GPS score of < 23 and 33.6% in those with a GPS score of > 39.

GPS was significantly associated with high-grade (tumor cells look very abnormal under the microscope) and non-organ confined cancer. Every 20-unit GPS increase increased the risk experiencing these by 3.2 times. 

GPS improved existing standard risk analysis by 90% when included when compared to using standard analysis alone.

There were no significant differences in GPS between African American and Caucasian patients in regards to GPS and expression of the biomarker genes used here.

The authors suggested that the Genomic Prostate Score can be used to predict cancer recurrence after radical prostatectomy with no racial disparities. 

Gleason Score 6 (a score of how abnormal tumors look under the microscope) tumors were more likely to be excluded from the experiment than others so result may be biased. 

If you are considering radical prostatectomy and would like more information on Genomic Prostate Score and biomarkers please consult your doctor.