| Home > Articles > Published articles > Development and Independent Validation of a Prognostic Gene Expression Signature Based on RB1, PTEN, and TP53 in Metastatic Hormone-sensitive Prostate Cancer Patients |
| Date: | 2024 |
| Abstract: | BACKGROUND: Androgen deprivation therapy (ADT) with docetaxel (D) and/or antiandrogen receptor therapies (ARTs) are the standard therapies in metastatic hormone-sensitive prostate cancer (mHSPC). Alterations in the tumor suppressor genes (TSGs) RB1, PTEN, and TP53 are associated with an aggressive evolution and treatment resistance in castration-resistant prostate cancer (CRPC). OBJECTIVE: To study the clinical implications of TSG mRNA expression in mHSPC patients. DESIGN, SETTING, AND PARTICIPANTS: This is a multicenter retrospective biomarker study in mHSPC patients. TSGlow status was defined when two or more out of the three TSGs presented low RNA expression by nCounter in formalin-fixed paraffin-embedded samples and TSGwt for the remaining cases. The microarray data from the CHAARTED trial were analyzed as an independent validation cohort. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Molecular data were correlated with CRPC-free survival (CRPC-FS) and overall survival (OS) by the Kaplan-Meier method and multivariate Cox analysis. RESULTS AND LIMITATIONS: A total of 226 patients were included, of whom 218 were eligible: 93 were treated with ADT and 125 with ADT + D; 75. 7% presented de novo stage IV and 67. 9% high-volume disease. TSGlow (19. 2%) was independently correlated with shorter CRPC-FS (hazard ratio [HR] 1. 8, p = 0. 002) and OS (HR 2, p = 0. 002). In the CHAARTED trial, TSGlow was independently correlated with lower CRPC-FS (HR 2. 2, p = 0. 02); no differences in clinical outcomes according to treatment were observed in TSGlow patients, while a significant benefit was observed for ADT + D in the TSGwt group for CRPC-FS (HR 0. 4, p < 0. 001) and OS (HR 0. 4, p = 0. 001). However, no interaction was observed between TSG signature and treatment in either series. Study limitations are the retrospective design, small sample size, and lack of inclusion of patients treated with ADT + ART. CONCLUSIONS: TSGlow expression correlates with adverse outcomes in patients with mHSPC. The investigation of new therapeutic strategies in these patients is warranted. PATIENT SUMMARY: The low RNA expression of tumor suppressor genes in the tumors is correlated with adverse outcomes in patients with metastatic hormone-sensitive prostate cancer. |
| Grants: | Instituto de Salud Carlos III PI18/714 Ministerio de Ciencia e Innovación RD09/0076/00036 Ministerio de Economía y Competitividad PT13/0010/0009 |
| Note: | Altres ajuts: Janssen-Pharmaceuticals (212082PCR4056); Astellas General Research Grant (71843877); Cancer Institute/ECOG-ACRIN Biostatistics Center (U10CA180820, U10CA180794, UG1CA233180) |
| Rights: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
| Language: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Subject: | Androgen deprivation therapy ; Biomarkers ; CHAARTED trial ; Docetaxel ; Hormone-sensitive prostate cancer ; Tumor suppressor genes |
| Published in: | European urology oncology, Vol. 7 Núm. 4 (August 2024) , p. 954-964, ISSN 2588-9311 |
11 p, 1.9 MB |