GU Symposium 2021: Novel Tool for Predicting Metastasis After Radiotherapy for Prostate Cancer
Posted: Monday, March 1, 2021
For men receiving dose-escalated radiation therapy—with or without androgen-deprivation therapy (ADT)—the combined clinical cell-cycle risk score (CCR) may accurately predict metastasis, according to findings presented at the 2021 Genitourinary (GU) Cancers Symposium (Abstract 195). CCR may offer clinically actionable information for recommended therapies based on National Comprehensive Cancer Center (NCCN) risk groups or Cancer of the Prostate Risk Assessment (CAPRA) scores, concluded Jonathan David Tward, MD, of the Huntsman Cancer Institute at the University of Utah, Salt Lake City, and colleagues.
“Men with scores below the multimodality threshold may not significantly reduce their 10-year risk of metastasis with the addition of ADT,” the authors said.
The investigators evaluated the CCR score and a CCR-based multimodality threshold score based on a multi-institutional group of men with NCCN intermediate- or high-risk localized disease. All 741 patients had received radiation therapy or ADT with radiation therapy.
After a median follow-up of 5.9 years, the authors found that a patient’s CCR score was a better prognosticator for metastasis (C-index = 0.78) than NCCN-risk group (C-index = 0.70), CAPRA score (C-index = 0.71), or cell-cycle progression score (CCP; C-index = 0.69). Bivariate analysis revealed that the CCR score remained predictive of metastasis when comparing patients who received and did not receive ADT, the duration of ADT as a continuous variable, or ADT use at or less than the recommended duration for each NCCN risk group.
Men with CCR scores below the threshold score (2.112) had a 10-year risk of 4.2% for metastasis, compared with a risk of 25.3% for those above the threshold. Those men who received radiation therapy alone with scores below the threshold had a 10-year risk of metastasis of 4.2%. In contrast, those who received radiation therapy plus ADT and were also below the threshold had a 10-year risk of 3.9%.
Disclosure: For full disclosure of the study authors, visit coi.asco.org.