Comprehensive Genomic Profiling Testing for Castration-Resistant Prostate Cancer in Advanced Elderly Patients: A Single-Center Retrospective Cohort Study.
{"title":"Comprehensive Genomic Profiling Testing for Castration-Resistant Prostate Cancer in Advanced Elderly Patients: A Single-Center Retrospective Cohort Study.","authors":"Takafumi Fukushima, Keisuke Goto, Yoshinori Nakano, Shinsaku Tasaka, Kyohsuke Iwane, Ryo Tasaka, Kohei Kobatake, Akihiro Goriki, Asuka Toshida, Akiko Abe, Misako Ishihara, Hikaru Nakahara, Masanori Motonaga, Kentaro Tokumo, Yasutoshi Fujii, Hayes Clair Nelson, Hiroaki Niitsu, Shinya Ohara, Yuji Urabe, Wataru Okamoto, Eiso Hiyama, Koji Arihiro, Takao Hinoi, Nobuyuki Hinata","doi":"10.1002/pros.24926","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is the second most common solid tumor in men, and its incidence is strongly dependent on age. With the aging global population, this poses a significant medical and sociodemographic issue. As treatment options for castration-resistant prostate cancer (CRPC) expand, the proportion of elderly patients with CRPC is expected to increase. Comprehensive genomic profiling (CGP) testing is becoming increasingly utilized for PCa; however, evidence on age-related outcomes or benefits is limited. This study aimed to evaluate the efficacy of CGP testing in advanced elderly patients with CRPC compared to younger patients.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study at Hiroshima University, including Japanese men aged ≥ 20 years who underwent CGP testing for CRPC between January 1, 2021, and May 31, 2024. Patients were categorized into the following two groups: the \"advanced elderly group\" (≥ 75 years) and the \"younger group\" (< 75 years). Clinical data were retrospectively extracted from medical records. CGP testing was performed using the FoundationOne® CDx, FoundationOne® Liquid CDx, Gurdant360® CDx, PleSSision Exome, or OncoGuide™ NCC Oncopanel System. Pathogenic alterations were categorized into relevant subgroups. Statistical analyzes were performed to compare patient backgrounds, genomic subgroups, and outcomes between the age groups.</p><p><strong>Results: </strong>Overall, 85 patients (median age: 74 years) were included in the analysis, with 38 and 47 in the advanced elderly and younger groups, respectively. No significant differences were observed in baseline clinical characteristics other than age. CGP testing identified 355 pathogenic variants (140 and 215 in the advanced elderly and younger groups, respectively), with similar distributions of alteration types across the two groups. Among the subgroups, DNA repair and homologous recombination repair-related gene alterations were significantly more frequent in the younger group (p = 0.017) than in the advanced elderly group. Overall survival (OS) did not differ significantly between the age groups. However, patients who received systemic chemotherapy based on CGP testing results had significantly better OS than those who did not receive systemic therapy (p = 0.045). This trend remained significant in the advanced elderly group (p = 0.006).</p><p><strong>Conclusions: </strong>CGP testing appears to offer clinical benefits for patients with CRPC, regardless of age.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1134-1142"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278702/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prostate","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pros.24926","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Prostate cancer (PCa) is the second most common solid tumor in men, and its incidence is strongly dependent on age. With the aging global population, this poses a significant medical and sociodemographic issue. As treatment options for castration-resistant prostate cancer (CRPC) expand, the proportion of elderly patients with CRPC is expected to increase. Comprehensive genomic profiling (CGP) testing is becoming increasingly utilized for PCa; however, evidence on age-related outcomes or benefits is limited. This study aimed to evaluate the efficacy of CGP testing in advanced elderly patients with CRPC compared to younger patients.
Methods: We conducted a single-center, retrospective cohort study at Hiroshima University, including Japanese men aged ≥ 20 years who underwent CGP testing for CRPC between January 1, 2021, and May 31, 2024. Patients were categorized into the following two groups: the "advanced elderly group" (≥ 75 years) and the "younger group" (< 75 years). Clinical data were retrospectively extracted from medical records. CGP testing was performed using the FoundationOne® CDx, FoundationOne® Liquid CDx, Gurdant360® CDx, PleSSision Exome, or OncoGuide™ NCC Oncopanel System. Pathogenic alterations were categorized into relevant subgroups. Statistical analyzes were performed to compare patient backgrounds, genomic subgroups, and outcomes between the age groups.
Results: Overall, 85 patients (median age: 74 years) were included in the analysis, with 38 and 47 in the advanced elderly and younger groups, respectively. No significant differences were observed in baseline clinical characteristics other than age. CGP testing identified 355 pathogenic variants (140 and 215 in the advanced elderly and younger groups, respectively), with similar distributions of alteration types across the two groups. Among the subgroups, DNA repair and homologous recombination repair-related gene alterations were significantly more frequent in the younger group (p = 0.017) than in the advanced elderly group. Overall survival (OS) did not differ significantly between the age groups. However, patients who received systemic chemotherapy based on CGP testing results had significantly better OS than those who did not receive systemic therapy (p = 0.045). This trend remained significant in the advanced elderly group (p = 0.006).
Conclusions: CGP testing appears to offer clinical benefits for patients with CRPC, regardless of age.
期刊介绍：
The Prostate is a peer-reviewed journal dedicated to original studies of this organ and the male accessory glands. It serves as an international medium for these studies, presenting comprehensive coverage of clinical, anatomic, embryologic, physiologic, endocrinologic, and biochemical studies.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
