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Updated: Apr 10, 2026

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Genomic Prostate Score (GPS) as a Prognostic Biomarker in Patients With Localized Prostate Cancer Undergoing Focal

Sriram Deivasigamani1, Srinath Kotamarti1, Mahdi Mottaghi2

  • 1Department of Urologic Surgery, Duke University Medical Center, Durham, North Carolina, USA.

The Prostate
|April 8, 2026
PubMed
Summary

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The Genomic Prostate Score (GPS) can help predict treatment failure and recurrence in men undergoing focal therapy for prostate cancer (PCa). Higher GPS scores indicate a greater risk of disease progression after focal ablation.

Area of Science:

  • Oncology
  • Urology
  • Genomics

Background:

  • Focal therapy (FT) offers a minimally invasive approach to prostate cancer (PCa) treatment, preserving healthy tissue and reducing complications.
  • However, the multifocal nature of PCa poses challenges for FT efficacy, with concerns about disease progression.
  • The utility of the Genomic Prostate Score (GPS) in risk-stratifying patients undergoing FT remains under investigation.

Purpose of the Study:

  • To evaluate the association between pretreatment biopsy-based Genomic Prostate Score (GPS) and oncological outcomes in patients with localized prostate cancer (PCa) treated with focal therapy (FT).
  • To determine if GPS can predict treatment failure (TF) and recurrence after FT.

Main Methods:

  • Retrospective review of a prospectively maintained database of 81 patients with localized PCa who underwent FT between 2005 and 2020.
Keywords:
Genomic Prostate Scorebiomarkercryoablationcryotherapyfocal therapyprostate cancer

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  • Analysis of preoperative prostate biopsy tissue for GPS assay.
  • Primary outcome: cumulative incidence of treatment failure (TF) and failure-free survival (FFS). Secondary outcome: prediction of ≥ Gleason Grade Group (GGG) 2 biopsy recurrence/persistence.

    • Main Results:

    • A GPS score > 40 was observed in 26% of patients.
    • Patients with GPS > 40 had a higher incidence of TF (53%) and biopsy recurrence (70%).
    • Univariable analysis showed GPS significantly associated with TF (HR 1.07) and biopsy recurrence (HR 1.09). Men with GPS 40-100 had significantly higher risk of TF (HR 4.19) and recurrence (HR 14.3).

    Conclusions:

    • The Genomic Prostate Score (GPS) assay demonstrates potential as a prognostic indicator for failure-free survival (FFS) and high-grade recurrence in patients undergoing focal ablation for localized prostate cancer (PCa).
    • These findings suggest GPS can aid in risk stratification for patients considering FT.
    • Larger studies are needed to confirm these results.