Grade Group System and Plasma Androgen Receptor Status in the First Line Treatment for Metastatic Castration Resistant Prostate Cancer

Overview

Journal Sci Rep

Specialty Science

Date 2022 May 5

PMID 35513478

Authors

M C Cursano

V Conteduca

E Scarpi

G Gurioli

C Casadei

S Gargiulo

A Altavilla

C Lolli

B Vincenzi

G Tonini

D Santini

U De Giorgi

Affiliations

Soon will be listed here.

Abstract

In localized prostate cancer (PCa), Grade Group (GG) and Gleason Score (GS) have a well-established prognostic role. In metastatic castration resistant prostate cancer (mCRPC), the prognostic role of GS and GG is less defined. In first-line treatment of mCRPC, androgen receptor (AR)-directed drugs (abiraterone acetate, enzalutamide) and docetaxel represent the referring options. There is no evidence that the GS/GG systems can add information to guide the choice between AR-directed drugs and docetaxel in the first-line setting of mCRPC. Nowadays there are no validated biomarkers, which define patients who may benefit or not from hormonal treatments or chemotherapy. Androgen receptor (AR) copy number variations (CNV) are predictive factors of poor response to abiraterone and enzalutamide. There are no available data about the association between AR CNV and GG. In this retrospective study, we analysed the association of the highest GG score with AR CNV and their impact on the clinical outcome of AR-directed drugs and docetaxel as first-line therapy for mCRPC patients. Patients benefit from docetaxel, abiraterone or enzalutamide regardless the GG. However, the presence of GG5 and AR CNV gain identifies a subgroup of patients with poor prognosis, which could benefit from front-line docetaxel instead of AR-directed drugs.

Citing Articles

Initial management approach for localized/locally advanced disease is critical to guide metastatic castration-resistant prostate cancer care.

Conteduca V, Di Tullio P, Allamprese R, Bruno G, Lolli C, Schepisi G Prostate Cancer Prostatic Dis. 2024; .

PMID: 38347113 DOI: 10.1038/s41391-024-00800-8.

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