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Updated: Jun 19, 2026
Sequencing Small Non-coding RNA from Formalin-fixed Tissues and Serum-derived Exosomes from Castration-resistant Prostate Cancer Patients
Published on: November 19, 2019
Real-world insights from comprehensive genomic profiling in patients with metastatic castration-resistant prostate
Yosuke Yasuda1, Soichiro Yoshida1, Sadakatsu Ikeda2
1Department of Urology, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
Introduction:
Comprehensive genomic profiling (CGP) has expanded treatment options for metastatic castration-resistant prostate cancer (mCRPC); however, real-world data on its clinical utility in Japanese patients remain limited. To address this gap, we conducted a multicenter real-world analysis to evaluate the implementation and clinical relevance of CGP in Japanese patients with mCRPC.
Methods:
We retrospectively analyzed 128 patients with mCRPC who underwent CGP at four Japanese institutions using FoundationOne® CDx, FoundationOne® Liquid CDx, or OncoGuide™ NCC Oncopanel. We assessed the prevalence of druggable genomic signatures, including BRCA pathogenic variants (PVs), microsatellite instability-high (MSI-high), and tumor mutational burden-high (TMB-high), and described subsequent use of genomically matched therapies.
Results:
The median age at CGP testing was 73 years, and patients had received a median of three prior systemic treatment lines. BRCA PVs were identified in 18 patients (14%), MSI-high in 4 (3%), and TMB-high in 11 (9%); all MSI-high cases were also TMB-high. Overall, 26 patients (20%) harbored either BRCA PVs or TMB-high status. Among these, 14 patients (54%) received matched targeted therapies, including poly(ADP-ribose) polymerase inhibitors or pembrolizumab. BRCA PVs were detected in 17% of tissue-based (F1 CDx) assays and 9% of liquid-based assays, without a statistically significant difference.
Conclusions:
CGP identified BRCA PVs, MSI-high, or TMB-high in 20% of patients with metastatic CRPC, supporting its value in guiding precision oncology. However, only some patients received matched therapy, supporting earlier CGP testing. Routine integration of CGP may facilitate precision oncology-guided treatment decision-making in this population.
