Nationwide Genomic Data Analysis of Japanese Prostate Cancer Patients From C-CAT Database

Prostate cancer is a leading malignancy among men, and genomic alterations are known to impact disease progression and treatment response. However, racial and ethnic differences may influence genomic profiles, necessitating population-specific analyses. This study aimed to characterize the genomic landscape and its clinical significance in Japanese patients with treatment-resistant, unresectable prostate cancer using data from the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database.

We analyzed data from patients with advanced or metastatic prostate cancer who had progressed after standard therapies and underwent comprehensive genomic profiling between 2019 and 2022. We assessed the frequency of genomic alterations, tumor mutation burden (TMB), and microsatellite instability (MSI) status. Associations between genomic features and clinical outcomes were also examined.

A total of 2634 patients were included. Family history was reported in 12.5% for prostate cancer, 1.5% for breast cancer, 5.2% for pancreatic cancer, and 1.1% for ovarian cancer. AR gene alterations were observed in 18% of patients. TP53 and BRCA2 mutations were identified in 34% and 12% of cases, respectively. Mutations in TP53, as well as alterations in genes related to the cell cycle, epigenetic regulation, MYC signaling, and the PI3K pathway, were associated with poorer overall survival.

This study provides a comprehensive overview of genomic alterations in advanced prostate cancer among Japanese patients and identifies key mutations linked to prognosis. These findings highlight the value of personalized prognostic assessment based on genomic profiling to guide clinical decision-making in this population.