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The CAPRA&PDE4D5/7/9 Prognostic Model Is Significantly Associated with Adverse Post-Surgical Pathology Outcomes.

Chloe Gulliver1, Sebastian Huss2, Axel Semjonow3

  • 1School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Science, University of Glasgow, Glasgow, G12 8QQ, UK.

Cancers
|January 8, 2023
PubMed
Summary
This summary is machine-generated.

A new clinical-genomics risk score, CAPRA&PDE4D5/7/9_BCR, accurately predicts post-surgical pathology outcomes in prostate cancer patients. This score identifies more low-risk patients for active surveillance than current criteria.

Keywords:
active surveillancemolecular biomarkerphosphodiesteraseprognosisprostate cancerrisk stratification

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Area of Science:

  • Urology
  • Oncology
  • Genomics

Background:

  • Prognostic risk scores are crucial for managing prostate cancer, particularly in low-to-intermediate risk patients.
  • Existing clinical criteria for active surveillance may not optimally identify patients who will benefit from treatment.
  • The CAPRA score is a clinical tool, while PDE4D gene expression offers genomic insights into prostate cancer progression.

Purpose of the Study:

  • To evaluate the association of a combined clinical-genomics risk score (CAPRA&PDE4D5/7/9_BCR) with post-radical prostatectomy pathological outcomes.
  • To compare the predictive performance of this score against established clinical criteria (PRIAS) for active surveillance selection.
  • To determine if the CAPRA&PDE4D5/7/9_BCR score can predict adverse pathology independently of clinical risk metrics.

Main Methods:

  • RNA was extracted from diagnostic needle biopsy tissue of 84 low-to-intermediate risk prostate cancer patients.
  • PDE4D5, PDE4D7, and PDE4D9 transcript levels were quantified using RT-qPCR.
  • A logistic regression model combined clinical data (CAPRA score) and gene expression data to create the CAPRA&PDE4D5/7/9_BCR risk score.

Main Results:

  • The CAPRA&PDE4D5/7/9_BCR risk score was significantly associated with all three investigated post-surgical pathology outcomes (adverse pathology, Gleason grade >2, Gleason grade >1).
  • In multivariable analysis, the genomics PDE4D5/7/9_BCR score independently predicted adverse pathology and Gleason grade >2.
  • The CAPRA&PDE4D5/7/9_BCR model identified more low-risk patients with a higher negative predictive value compared to PRIAS criteria.

Conclusions:

  • The clinical-genomics CAPRA&PDE4D5/7/9_BCR risk score effectively predicts post-surgical pathology outcomes in prostate cancer.
  • This score offers independent predictive value for adverse pathology, outperforming current clinical active surveillance criteria.
  • The CAPRA&PDE4D5/7/9_BCR score may improve patient selection for active surveillance, enhancing the identification of those with unfavorable outcomes.