ProstaTrend-A Multivariable Prognostic RNA Expression Score for Aggressive Prostate Cancer.

Area of Science:

• Oncology
• Genomics
• Biomarker Discovery

Background:

• Prostate cancer (PCa) exhibits variable clinical behavior, necessitating improved prognostic biomarkers.
• Current clinical parameters require enhancement for precise identification of aggressive PCa.
• Accurate risk stratification is crucial for effective PCa management.

Purpose of the Study:

• To develop an RNA expression-based score for predicting PCa prognosis.
• To create a tool that aids clinical decision-making in PCa management.
• To identify novel gene expression patterns associated with PCa aggressiveness.

Main Methods:

• Transcriptome-wide sequencing and microarray analysis of 233 PCa tissue specimens.
• Application of Cox proportional hazard models and meta-analysis to identify predictive genes.
• Development and validation of the ProstaTrend score using independent cohorts, including TCGA data.

Main Results:

• The ProstaTrend score, comprising ~1400 genes, significantly predicted time to death from disease (DoD) in a training cohort (p=2e-09).
• ProstaTrend also accurately predicted biochemical recurrence (BCR) in an independent validation cohort (p=3e-06).
• The score's prognostic impact remained significant after adjusting for established clinical factors like Gleason grading group and resection status.

Conclusions:

• ProstaTrend is a validated transcriptome-based score for predicting DoD and BCR in PCa patients post-radical prostatectomy.
• This score offers molecular patient risk stratification, improving post-surgical management.
• ProstaTrend represents a significant advancement in personalized medicine for prostate cancer.