Gene expression signatures in biopsy cores as predictors of coexisting higher-grade disease in Gleason group 1 prostate cancer: Results from the Miami MAST prospective clinical trial.

• DOI: 10.1200/jco.2025.43.5_suppl.239
• Publication Date: 2025-02-18T14:43:07Z
• Authors: David J Lee; Brandon A. Mahal; Sanoj Punnen
• Keywords: Prostate biopsy

239 Background: Despite several improvements in Active Surveillance (AS), pathologic reclassification remains frequent. Therefore, we examined if gene expression signatures biopsy cores with Gleason Group (GG) 1 cancer can predict coexisting higher-grade disease elsewhere the prostate among participants of Miami Trial (MAST). Methods: MAST enrolled 205 men low and favorable intermediate-risk undergoing AS. Participants underwent an MRI confirmatory at enrollment, annually thereafter for three years. Positive profiling whole-transcriptome Decipher genomic classifier (DGC). Derived Genomic Prostate Score (dGPS) Cell Cycle Progression (dCCP) were obtained. The primary objective was to compare signature scores GG1 from prostates (positive) vs. without (negative) GG2+ elsewhere. also compared GG3+ elsewhere, a sub-analysis using only highest-volume core each session performed. Results: There no significant difference between groups DGC or dCCP regarding objective, whereas median (IQR) dGPS 0.14 (0.08–0.24) positive 0.10 (0.07–0.16) negative (p=0.018). For again did not differ, while 0.24 (0.19–0.29) groups, respectively (p=0.005). In highest volume biopsy, as is usual standard care when testing on tissue, there score any signatures. Conclusions: Neither GC, dCCP, nor showed clinically differences testing. Our findings suggest that foci are heterogeneous genomically independent. Clinical trial information: NCT02242773 .