Abstract CT129: Identifying molecular determinants of response to apalutamide (APA) in patients (pts) with nonmetastatic castration-resistant prostate cancer (nmCRPC) in the SPARTAN study

Feng, Felix Y.; Thomas, Shibu; Gormley, Michael; Lopez-Gitlitz, Angela; Yu, Margaret K.; Cheng, Shinta; Ricci, Deborah; Rooney, Brendan; Mainwaring, Paul N.; Olmos, David; Saad, Fred; Hadaschik, Boris; Fishbane, Nick; Davicioni, Elai; Liu, Yang; Small, Eric J.; Smith, Matthew R.

doi:10.1158/1538-7445.sabcs18-ct129

Cited by 2 publications

(1 citation statement)

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“…Considering the heterogeneity of nmCRPC, however, incorporating both PSA thresholds and genomic plus clinical variables might help best select the patients at greatest risk for near-term progression to symptomatic metastatic disease, who might benefit most from additional treatment. Relevant data on the DECIPHER test have been presented for a subset of SPARTAN participants showing that patients with high DECIPHER scores may have greater benefit from apalutamide therapy [75], but no ongoing phase III trials are investigating genomic testing for risk stratification in nmCRPC.…”

Section: Discussionmentioning

confidence: 99%

Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

Vogl

Beer

Davis

et al. 2022

European Journal of Cancer

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Section: Discussionmentioning

confidence: 99%

Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

Vogl

Beer

Davis

et al. 2022

European Journal of Cancer

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Prospective study to define the clinical utility and benefit of Decipher testing in men following prostatectomy

Marascio

Spratt

Zhang

et al. 2019

Prostate Cancer Prostatic Dis

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Background Genomic classifiers (GC) have been shown to improve risk stratification post prostatectomy. However, their clinical benefit has not been prospectively demonstrated. We sought to determine the impact of GC testing on postoperative management in men with prostate cancer post prostatectomy. Methods Two prospective registries of prostate cancer patients treated between 2014 and 2019 were included. All men underwent Decipher tumor testing for adverse features post prostatectomy (Decipher Biosciences, San Diego, CA). The clinical utility cohort, which measured the change in treatment decision-making, captured pre-and postgenomic treatment recommendations from urologists across diverse practice settings (n = 3455). The clinical benefit cohort, which examined the difference in outcome, was from a single academic institution whose tumor board predefined "best practices" based on GC results (n = 135). Results In the clinical utility cohort, providers' recommendations pregenomic testing were primarily observation (69%). GC testing changed recommendations for 39% of patients, translating to a number needed to test of 3 to change one treatment decision. In the clinical benefit cohort, 61% of patients had genomic high-risk tumors; those who received the recommended adjuvant radiation therapy (ART) had 2-year PSA recurrence of 3 vs. 25% for those who did not (HR 0.1 [95% CI 0.0-0.6], p = 0.013). For the genomic low/intermediate-risk patients, 93% followed recommendations for observation, with similar 2year PSA recurrence rates compared with those who received ART (p = 0.93). Conclusions The use of GC substantially altered treatment decision-making, with a number needed to test of only 3. Implementing best practices to routinely recommend ART for genomic-high patients led to larger than expected improvements in early biochemical endpoints, without jeopardizing outcomes for genomic-low/intermediate-risk patients.

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Abstract CT129: Identifying molecular determinants of response to apalutamide (APA) in patients (pts) with nonmetastatic castration-resistant prostate cancer (nmCRPC) in the SPARTAN study

Cited by 2 publications

References 0 publications

Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

Prospective study to define the clinical utility and benefit of Decipher testing in men following prostatectomy

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