domingo, 1 de octubre de 2017

Validation of GEMCaP as a DNA based biomarker to predict prostate cancer recurrence after radical prostatectomy. - PubMed - NCBI

2017 Sep 20. pii: S0022-5347(17)77554-4. doi: 10.1016/j.juro.2017.09.071. [Epub ahead of print]

Validation of GEMCaP as a DNA based biomarker to predict prostate cancer recurrence after radical prostatectomy.

Nguyen HG1, Welty C1, Lindquist K1, Ngo V1, Gilbert E1, Bengtsson H2, Magi-Galluzzi C3, Jean-Gilles J4, Yao J4, Cooperberg M1, Messing E5, Klein EA6, Carroll PR1, Paris PL7.

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Abstract

PURPOSE:

We aim to validate the Genomic Evaluators of Metastatic Cancer of the Prostate (GEMCaP) as a novel copy number signature predictive for prostate cancer recurrence.

MATERIALS AND METHODS:

We randomly selected patients who had radical prostatectomy at the Cleveland Clinic (CC) or the University of Rochester (UR) from 2000-2005. DNA isolated from the cancer region was extracted and subjected to high resolution array comparative genomic hybridization (aCGH). A high GEMCaP score was defined as >20% of the genomic loci exhibiting copy number gain or loss in a given tumor. Cox regression was used to evaluate associations between the GEMCaP score and risk of biochemical recurrence.

RESULTS:

We report the results from 140 patients. Overall, 38% of patients recurred with a median time to recurrence of 45 months. Based on the CAPRA-S score, 39% were low-risk, 42% were intermediate-risk and 19% were high-risk. Thirty-one percent of the cohort had a high GEMCaP score (≥20%). A high GEMCaP score was associated with higher risk of biochemical recurrence (HR 2.69, 95% CI 1.51-4.77) and remained associated after adjusting for the CAPRA-S score and age (HR 1.94, 95% CI 1.06-3.56). The C-index for GEMCaP alone was 0.64, and improved when combined with CAPRA-S and age (C-index = 0.75).

CONCLUSIONS:

A high GEMCaP score was associated with biochemical recurrence in two external cohorts. This remained true after adjusting for clinical and pathologic factors. The GEMCaP biomarker could be an efficient and effective clinical risk assessment tool to identify prostate cancer patients for early adjuvant therapy.