Prognostic Biomarkers in Active Surveillance: Parsing Risk in Early-Stage Prostate Cancer
Technical Report,01 Aug 2018,31 Jul 2019
Beth Israel Deaconess Medical Center Boston United States
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While a majority of prostate cancers PCa remain clinically insignificant, some have the potential to metastasize and become lethal and therefore merit intervention. Thus, identification of men most at risk and most likely to benefit from therapy is a major clinical and public health challenge. Recent evidence suggests that the clinical-pathologic criteria used to assess eligibility for active surveillance and to define progression requiring intervention do not capture molecular changes that may more accurately predict progression of tumors from indolent to aggressive. Based on published results and preliminary data, we hypothesize that truly indolent Gleason pattern Gp 3 tumors are a molecularly distinct subset from potentially aggressive Gp3. During this period, we evaluated somatic copy number alteration SCNA landscape between tumor foci from patients who did not progress with long-term follow-up on active surveillance versus those from patients who did have to pursue primary therapy. We identified an overall quiet SCNA landscape in clinically indolent prostate cancer. We also evaluated circulating tumor DNA ctDNA as a biomarker in perioperative plasma samples from patients undergoing prostatectomy for intermediatehigh-risk disease and found limited amounts of ctDNA.
- Medicine and Medical Research
- Anatomy and Physiology