Abstract 1617P
Background
We determined the performance of a multi-gene copy number variation (CNV) risk score in tissue and plasma cell-free DNA (cfDNA) biospecimens obtained in treatment- naïve metastatic castrate-resistant prostate cancer (mCRPC) patients to predict survival outcomes.
Methods
Metastatic tissue and cfDNA biospecimen sequencing results for CNV gains in AR, MYC, COL22A1, PIK3CA, PIK3CB, NOTCH1 and losses in TMPRSS2, NCOR1, ZPTB18, TP53, NKX3-1 from three independent treatment-naïve mCRPC cohorts (dbGaP, SU2C/PCF and the Vancouver Prostate Centre-University of British Columbia-VPC/BC) were used to to calculate a multi-gene weighted CNV risk score in all cohorts. Survival outcomes included overall survival (OS) and progression free survival (PFS) to first-line abiraterone-acetate/prednisone (AA/P) or enzalutamide (E) therapies adminsitered as mCRPC treatment in a specific cohort. The range of the risk scores obtained in each cohort was dichotomized at the median into a “high-risk” score (above median) and “low-risk” score (below median) and association with OS/PFS performed. Univariate and multi-variate Cox Proportional Hazard Regressions were applied for survival analyses (P<0.05 for significance).
Results
Of 1137 metastatic tissue-cfDNA biospecimens, 662/1137 were treatment-naive for mCRPC therapies and 311 were matched metastatic tissue - cfDNA pairs. The table summarizes results of comparisons between “high” and “low-risk” scores and survivals in each cohort. Pts with high-risk scores derived from metastatic tissue or cfDNA in all cohorts at the univariate and multi-variate level had the shortest OS. High risk scores also had shorter time to response to first-line AA/P and E therapies. Table: 1617P
Risk-score based survival in each independent cohort
| Range of CNV risk score in the cohort(Median) | Number of high risk vs low risk patients (pts) per cohort(N) | Median OS for high vs low risk (Months)(P-value) | Median PFS for high vs low risk scores for AA/P or E (Months)(P-value) | |
| dbGaP metastatic tissue cohort (N=68) | -0.11 to 4.01 (0.37) | 30 vs 38 | 24.9 vs 30.6 P=0.039 | For AA/P 7.8 vs 14 (P=0.0064) |
| SU2C/PCF metastatic tissue cohort (N=98) | -0.35 to 4.11 (2.23) | 49 vs 49 | 22.2 vs 33.7 P=0.003 | Not applicable |
| VPC/BC cfDNA cohort (N=311) | 0 - 9.4 (0) | First-line AA/P (N=137 pts) 51 vs 86 First-line E (N=174 pts)71 vs 103 | 15.5 vs 38.8 PConclusionsA multi-gene CNV risk score predicts survival outcomes and therapy responses to first-line AA/P and E in treatment-naive mCRPC patients and can be used for designing future enrichment type clinical trials. Clinical trial identificationPROMOTE (Prostate Cancer Medically-Optimized Genome-Enhanced Therapy), NCT01953640. Editorial acknowledgementLegal entity responsible for the studyManish Kohli. FundingHas not received any funding. DisclosureM. Kohli: Non-Financial Interests, Personal, Non remunerated activity, Travel only: Triomics Inc.; Non-Financial Interests, Personal, Non remunerated activity, Non-compensated: Nferene Inc. C. Maurice-Dror: Financial Interests, Personal, Financially compensated role, Advisory board/Honoraria/Travel: Jansen, Merck; Financial Interests, Personal, Financially compensated role, Honoraria/Travel: Pfizer; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Financially compensated role: Biomica. A.W. Wyatt: Financial Interests, Personal, Advisory Board: AstraZeneca, Bayer, Pfizer, Merck, Janssen, EMD Serono; Financial Interests, Institutional, Research Funding: ESSA Pharma, Tyra Biosciences. B. Schmidt: Financial Interests, Personal, Advisory Board: ImmunityBio. All other authors have declared no conflicts of interest. Resources from the same session1647P - Clinical validity of plasma DNA testing to identify BRCA-mutated (BRCA+) patients in the MAGNITUDE studyPresenter: Gerhardt Attard Session: Poster session 11 1649P - Impact of concomitant medications on safety in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC) receiving rezvilutamide (Rez) plus androgen-deprivation therapy (ADT): A post-hoc analysis of the randomized phase III CHART trialPresenter: Dingwei Ye Session: Poster session 11 1650P - Fuzuloparib plus abiraterone acetate and prednisone (AA-P) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): A phase I studyPresenter: Tao Dai Session: Poster session 11 1651P - Characteristics, tolerance and effectiveness of patients aged more or less than 75 years treated with [177Lu]Lu-PSMA-617 as part of France’s early access programPresenter: David Tonnelet Session: Poster session 11 1652P - SAABR: Single arm phase II study of androgen receptor pathway inhibitor (ARPI) + atezolizumab + GnRH analog (ADT) and stereotactic body radiotherapy (SBRT) to the prostate in men with de novo hormone-sensitive metastatic prostate cancer (mHSPC)Presenter: Dana Rathkopf Session: Poster session 11 1653P - Molecular and immunologic correlates of high PSMA/FOLH1 mRNA expression in prostate cancer (PC)Presenter: Rana McKay Session: Poster session 11 1654P - TAMARACK: Randomized Phase II trial of the B7-H3 targeting antibody drug conjugate (ADC) vobramitamab duocarmazine (vobra duo) in metastatic castration-resistant prostate cancer (mCRPC)Presenter: Johann de Bono Session: Poster session 11 1655P - Association of location of BRCA1/2 pathogenic variants with benefit from PARP-inhibitors in metastatic castration-resistant prostate cancers: Results from the PROGRESS studyPresenter: Lorena Incorvaia Session: Poster session 11 1656TiP - The STAMPEDE2 niraparib-abiraterone acetate + prednisolone trial: A phase III, randomised, open-label trial in patients with metastatic prostate cancer (mPC) with a deleterious alteration in a homologous recombination repair (HRR) gene starting androgen deprivation therapy (ADT)Presenter: Sarah Howlett Session: Poster session 11 This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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