Prostate Cancer: Assay Leads To Increased Active Surveillance Use

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AS is recommended for men with low-risk PCa; this option can mitigate treatment-related reduction in quality of life.
AS is recommended for men with low-risk PCa; this option can mitigate treatment-related reduction in quality of life.

The 17-Gene Genomic Prostate Score (GPS) assay increases the use of active surveillance (AS) among men with low-risk prostate cancer (PCa), according to a study published in Reviews in Urology.1

AS is recommended for men with low-risk PCa; this option can mitigate treatment-related reduction in quality of life. GPS — a molecular assay used to assess the likelihood of high-grade disease and metastases in prostate cancer — and MRI are 2 frequently used stratification methods for treatment decision-making among men with low-risk disease.  

For this retrospective cohort study, researchers accessed the Optum Research Database to analyze the claims data of 8920 men with PCa who underwent GPS and/or prostate MRI. Eligible patients were low-risk, newly diagnosed, had clinical activity for at least 12 months before and 6 months after diagnosis, and had at least 1 prostate-specific antigen (PSA) measurement within 12 months before or after diagnosis. About 81% of patients had 12 months of follow-up data.

Four percent (375) of patients compared with 13% (1174) underwent GPS or MRI, respectively, and the range of AS use varied from 43% for men who underwent MRI only to 89% for men who underwent GPS only.

After 6 months, the rate of AS use was 31% higher among those who underwent GPS than those who underwent neither GPS nor MRI (95% CI, 27.6%-34.5%; P < .001); by 12 months, the difference was 30.5%.

The authors concluded that “combined with the results of other studies from multiple settings, GPS testing is consistently associated with higher rates of AS compliance compared with MRI or no GPS/MRI testing at all.”

References

  1. Canfield S, Kemeter MJ, Hornberger J, Febbo PG. Active surveillance use among a low-risk prostate cancer population in a large US payer system: 17-Gene Genomic Prostate Score versus other risk stratification methods. Rev Urol. 2017;19(4):203-12. doi: 10.3909/riu0786

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