The following is a summary of “Identification of a Predictive Genomic Biomarker for Prostate-directed Therapy in Synchronous Low-volume Metastatic Castration-sensitive Prostate Cancer,” published in the August 2023 issue of Oncology by Sutera et al.

Prostate-directed therapy (PDT) for low-volume metastatic castration-sensitive prostate cancer (mCSPC) improves overall survival (OS), tumor genomics for clinical trajectory. Researchers performed a retrospective study to analyze high-risk genomic signature (HiRi) for predicting benefit from PDT.

The study included men (101 patients) with synchronous low-volume mCSPC who had their tumors sequenced. Patients were classified based on HiRi mutation (TP53, ATM, BRCA1, BRCA2, Rb1). They evaluated the effect of PDT on OS in patients with and without HiRi mutation using Kaplan-Meier, log-rank test, and Cox regression.

Results demonstrated that half had a HiRi pathogenic mutation (49%). Patients with HiRi mutations had a median OS of 73 months without PDT and 66.8 months with PDT (P= 0.3). In contrast, patients without HiRi mutations showed improved OS of 60 months without PDT and 105.3 months with PDT (P< 0.001). The interaction’s P-value for OS between PDT and HiRi mutation was highly significant (P< 0.001). The study’s limitations was its retrospective nature.

The study concluded that HiRi genomic biomarker predicts lack of benefit from PDT in mCSPC.

Source: pubmed.ncbi.nlm.nih.gov/37558543/