Document Type
Article
Publication Date
9-2-2022
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.
Recommended Citation
Awasthi, Shivanshu; Grass, G. Daniel; Torres-Roca, Javier; Johnstone, Peter A. S.; Pow-Sang, Julio; Dhillon, Jasreman; Park, Jong; Rounbehler, Robert J.; Davicioni, Elai; Hakansson, Alex; Liu, Yang; Fink, Angelina K.; DeRenzis, Amanda; Creed, Jordan H.; Poch, Michael; Li, Roger; Manley, Brandon; Fernandez, Daniel; Naghavi, Arash; Gage, Kenneth; Lu-Yao, Grace; Katsoulakis, Evangelia; Burri, Ryan J.; Leone, Andrew; Ercole, Cesar E.; Palmer, Joshua D.; Vapiwala, Neha; Deville, Curtiland; Rebbeck, Timothy R.; Dicker, Adam P.; Kelly, William; and Yamoah, Kosj, "Genomic Testing in Localized Prostate Cancer Can Identify Subsets of African Americans With Aggressive Disease" (2022). Department of Medical Oncology Faculty Papers. Paper 219.
https://jdc.jefferson.edu/medoncfp/219
Creative Commons License
This work is licensed under a
Creative Commons Public Domain Dedication 1.0 License.
PubMed ID
36053178
Language
English
Included in
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Oncology Commons
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.