We’re excited to share the GPS study “Association of Genomic Prostate Score at Positive Margin with Recurrence after Radical Prostatectomy,” which was recently published in the British Journal of Urology International Journal. Additionally, we’d like to recogniza one of our own, JP Zambon, MD, for his contribution to the publication. The study was performed in partnership with Johns Hopkins University School of Medicine and assessed whether the GPS assay at the positive surgical margin could help stratify prognosis and inform clinical decision-making regarding adjuvant therapy after radical prostatectomy.
View here: https://pubmed.ncbi.nlm.nih.gov/38953550/
Summary
The study is a retrospective analysis of a cohort of 203 men selected from 813 RP patients treated at Johns Hopkins from 2008 to 2017 with positive margins. We evaluated the utility of the GPS performed on prostate cancer at the positive margin of the RP for its association with the risk of subsequent biochemical recurrence (BCR). The median age was 60, and the median PSA was 6 ng/mL. Of 203 patients, 71 (35%) had biopsy Gleason Grade 1, 73 (36%) had biopsy Gleason Grade 2, 143 (70%) had clinical stage T1b/T1c, and 33 (16%) had T2a. The median length of the positive margin was 2 mm; 110 (54%) patients had Gleason Grade 1, and 47 (23%) had Gleason Grade 2 at the positive margin. The median GPS was 31 (23-41), and 54 (27%) patients had GPS>40. In univariable analysis, every 20-unit increase in the GPS was associated with a nearly 3-fold increase in the risk of BCR (HR/20 units 2.82, p<0.001). In multivariable analysis, the GPS was significantly associated with BCR (HR/20 units 1.56, p=0.011) after adjusting for age, race, CAPRA score, Grade Group at the positive margin, and adjuvant radiation therapy. Although clinical trials are required to evaluate the GPS at the surgical margin, this study demonstrates the utility of the GPS performed at the surgical margin as a predictive biomarker of post-RP treatment intensification in patients with higher-risk prostate cancer.
Key Points
· GPS performed at the positive surgical margin was an independent prognostic biomarker of BCR, in uni- and multivariable analysis, in patients with higher-risk prostate cancer treated with radical prostatectomy.
· GPS results were associated with a 3-fold increase in risk of BCR as a continuous (20-unit increase) and dichotomous (>40 vs. <40) variable.
· GPS results at the positive surgical margins could help stratify prognosis and inform clinical decision-making regarding adjuvant therapy after radical prostatectomy.
Abadchi, Association of GPS at positive margin with recurrence after RP, BJU Int 2024