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Sandy Srinivas, MD


Genomic Classifiers as Prognostic Factors for Androgen-Deprivation Therapy for Advanced Prostate Cancer

By: Justine Landin, PhD
Posted: Monday, October 10, 2022

Clinical outcomes following androgen-deprivation therapy in combination with abiraterone acetate and prednisolone (AAP) may vary based upon genomic classifiers and androgen-receptor activation for patients with advanced prostate cancer, according to preliminary results from an ancillary study of the STAMPEDE AAP trial. These findings were presented by Marina Parry, MD, of University College London, and colleagues during the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract 1358O).

“Addition of AAP to androgen-deprivation therapy is standard of care for advanced prostate cancer (metastatic and high-risk nonmetastatic). We tested transcriptome signatures as prognostic and predictive biomarkers for patients starting androgen-deprivation therapy with or without AAP,” stated the study investigators.

Enrolled patients who passed quality control (n = 781) with metastatic or high-risk nonmetastatic prostate cancer were randomly assigned to receive androgen-deprivation therapy alone or androgen-deprivation therapy plus AAP. The clinical test Decipher was used to identify tumor index core mRNA signatures. Genomic classifiers and androgen-receptor activity were identified via Cox models as predictors for response outcomes within treatment groups.

At the median follow-up of 94 months, genomic classifiers were found to be prognostic for overall survival, for both metastatic (per 0.1 increment, hazard ratio [HR] = 1.17, P < .001) and high-risk, nonmetastatic samples of advanced prostate cancer (HR = 1.20, P < .001). Average activation of androgen receptors was not found to be interactive with AAP treatment (P = .5). There was also a consistent effect of androgen-deprivation therapy plus AAP observed in patients with PAM50 mRNA expression and genomic classifiers. However, androgen deprivation plus AAP appeared to worsen overall survival in those with low androgen-receptor activation (P = .02).

Disclosure: For full disclosures of the study authors, visit

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