Comprehensive Genomic Profiling Testing for Castration-Resistant Prostate Cancer in Advanced Elderly Patients: A...

Area of Science:

• Oncology
• Genomics
• Geriatrics

Background:

• Prostate cancer (PCa) is a leading cancer in men, with incidence increasing with age.
• The aging population means more elderly patients will face castration-resistant prostate cancer (CRPC).
• Comprehensive genomic profiling (CGP) is increasingly used, but its age-specific benefits in CRPC are unclear.

Purpose of the Study:

• To evaluate the efficacy of CGP testing in advanced elderly CRPC patients compared to younger CRPC patients.
• To compare clinical characteristics, genomic alterations, and outcomes between age groups.

Main Methods:

• Retrospective cohort study of 85 Japanese men with CRPC undergoing CGP testing.
• Patients divided into advanced elderly (≥75 years) and younger (<75 years) groups.
• Analysis of clinical data, CGP results (FoundationOne® CDx, etc.), and survival outcomes.

Main Results:

• No significant differences in baseline characteristics or CGP alteration types between age groups.
• DNA repair and homologous recombination repair gene alterations were more frequent in younger patients (p=0.017).
• Overall survival did not differ by age, but CGP-guided chemotherapy improved survival (p=0.045), especially in the advanced elderly group (p=0.006).

Conclusions:

• CGP testing provides clinical benefits for CRPC patients across different age groups.
• CGP-guided systemic therapy demonstrates improved survival outcomes, particularly in elderly CRPC patients.