Authors

Shivanshu Awasthi, H. Lee Moffitt Cancer Center & Research Institute
G. Daniel Grass, H. Lee Moffitt Cancer Center & Research Institute
Javier Torres-Roca, H. Lee Moffitt Cancer Center & Research Institute
Peter A. S. Johnstone, H. Lee Moffitt Cancer Center & Research Institute
Julio Pow-Sang, H. Lee Moffitt Cancer Center & Research Institute
Jasreman Dhillon, H. Lee Moffitt Cancer Center & Research Institute
Jong Park, H. Lee Moffitt Cancer Center & Research Institute
Robert J. Rounbehler, H. Lee Moffitt Cancer Center & Research Institute
Elai Davicioni, Veracyte Inc
Alex Hakansson, Veracyte Inc
Yang Liu, Veracyte Inc
Angelina K. Fink, H. Lee Moffitt Cancer Center & Research Institute
Amanda DeRenzis, H. Lee Moffitt Cancer Center & Research Institute
Jordan H. Creed, H. Lee Moffitt Cancer Center & Research Institute
Michael Poch, H. Lee Moffitt Cancer Center & Research Institute
Roger Li, H. Lee Moffitt Cancer Center & Research Institute
Brandon Manley, H. Lee Moffitt Cancer Center & Research Institute
Daniel Fernandez, H. Lee Moffitt Cancer Center & Research Institute
Arash Naghavi, H. Lee Moffitt Cancer Center & Research Institute
Kenneth Gage, H. Lee Moffitt Cancer Center & Research Institute
Grace Lu-Yao, Thomas Jefferson UniversityFollow
Evangelia Katsoulakis, James A. Haley Veterans Hospital
Ryan J. Burri, Bay Pines VA Healthcare System
Andrew Leone, Bay Pines VA Healthcare System
Cesar E. Ercole, James A. Haley Veterans Hospital
Joshua D. Palmer, Ohio State University
Neha Vapiwala, University of Pennsylvania
Curtiland Deville, Johns Hopkins University
Timothy R. Rebbeck, Harvard University
Adam P. Dicker, Thomas Jefferson University
William Kelly, Thomas Jefferson University
Kosj Yamoah, H. Lee Moffitt Cancer Center & Research Institute

Document Type

Article

Publication Date

9-2-2022

Comments

This article is the author's final published version in Journal of the National Cancer Institute, Volume 114, Issue 12, December 2022, Pg. 1656 - 1664.

The published version is available at https://doi.org/10.1093/jnci/djac162. Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Abstract

BACKGROUND: Personalized genomic classifiers have transformed the management of prostate cancer (PCa) by identifying the most aggressive subsets of PCa. Nevertheless, the performance of genomic classifiers to risk classify African American men is thus far lacking in a prospective setting.

METHODS: This is a prospective study of the Decipher genomic classifier for National Comprehensive Cancer Network low- and intermediate-risk PCa. Study-eligible non-African American men were matched to African American men. Diagnostic biopsy specimens were processed to estimate Decipher scores. Samples accrued in NCT02723734, a prospective study, were interrogated to determine the genomic risk of reclassification (GrR) between conventional clinical risk classifiers and the Decipher score.

RESULTS: The final analysis included a clinically balanced cohort of 226 patients with complete genomic information (113 African American men and 113 non-African American men). A higher proportion of African American men with National Comprehensive Cancer Network-classified low-risk (18.2%) and favorable intermediate-risk (37.8%) PCa had a higher Decipher score than non-African American men. Self-identified African American men were twice more likely than non-African American men to experience GrR (relative risk [RR] = 2.23, 95% confidence interval [CI] = 1.02 to 4.90; P = .04). In an ancestry-determined race model, we consistently validated a higher risk of reclassification in African American men (RR = 5.26, 95% CI = 1.66 to 16.63; P = .004). Race-stratified analysis of GrR vs non-GrR tumors also revealed molecular differences in these tumor subtypes.

CONCLUSIONS: Integration of genomic classifiers with clinically based risk classification can help identify the subset of African American men with localized PCa who harbor high genomic risk of early metastatic disease. It is vital to identify and appropriately risk stratify the subset of African American men with aggressive disease who may benefit from more targeted interventions.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Public Domain Dedication 1.0 License.

PubMed ID

36053178

Language

English

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