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Do Homologous Recombination Deficiency Scores Have Prognostic Value in Aggressive Prostate Cancer?

By: Kayci Reyer
Posted: Friday, October 14, 2022

Research presented in BMC Medicine suggests that homologous recombination deficiency (HRD) scores may have prognostic value in some aggressive prostate cancers. High HRD scores seem to be associated with significantly worse survival among patients with high-risk localized and de novo metastatic prostate cancers, including those with intraductal carcinoma of the prostate.

“This is very informative to clinicians, since conventional prognostic markers such as the Gleason score can be of little use in stratifying highly aggressive diseases,” noted Hao Zeng, MD, of Sichuan University, China, and colleagues. “With the help of HRD score results, clinicians are able to consider more upfront therapies and pay extra attention to the efficacy of PARP inhibitors in patients with high HRD scores.”

The study included 123 patients who had been diagnosed with either M0 (n = 46) or M1 (n = 77) prostate cancer at West China Hospital between 2015 and 2020. Tissue samples from each patient underwent HRD score assessment and genomic alteration testing.

A total of 65 patients (52.8%) had an HRD score of at least 21, the median overall score. HRD scores were higher among patients with intraductal carcinoma of the prostate than among those with adenocarcinoma. Patients with M1 disease, an International Society of Urological Pathology disease grade 4 or 5, or MYC mutations were more likely to have high HRD scores. High HRD scores were associated with TP53 mutations in patients with intraductal carcinoma and with HRR pathway mutations in patients with a disease other than intraductal carcinoma. Overall, survival was substantially worse for patients with HRD scores above 21.

Disclosure: The study authors reported no conflicts of interest.

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